NPI | 1447016035 |
---|---|
Other Name | AUTUMN LAKE PACC LTC SMG NEPH |
Entity Type | Organization |
Authorized Contact | KRYSTLE BROWN Billing Manager 410-870-9380 |
Organization Subpart ? | No |
Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
Additional Taxonomies | 207R00000X Internal Medicine |
Enumeration Date | 2024-02-22 |
Last Update Date | 2024-07-23 |