| NPI | 1437399482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY CARSON Manager, Payer Enrollment 234-312-5691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 207RR0500X Internal Medicine Rheumatology | |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| 207RS0012X Internal Medicine Sleep Medicine | |
| 207Y00000X Otolaryngology | |
| 208800000X Urology | |
| 208VP0000X Pain Medicine Pain Medicine | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2009-03-04 |
| Last Update Date | 2024-08-15 |