| NPI | 1427281203 |
|---|---|
| Doing Business As | PMG MT BROADWAY INTERNAL MED |
| Entity Type | Organization |
| Authorized Contact | KIRK BODLOVIC CFO 4065-643-7271 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2013-11-26 |