| 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 |