NPI | 1457972366 |
---|---|
Doing Business As | SSM HEALTH MEDICAL GROUP HEALTHPLEX EAST PEDIATRICS |
Entity Type | Organization |
Authorized Contact | CRYSTAL L PENA Provider Enrollment Specialist 405-272-7452 |
Organization Subpart ? | Yes |
Primary Taxonomy | 208000000X Pediatrics |
Enumeration Date | 2020-05-01 |
Last Update Date | 2020-05-01 |