| NPI | 1508098344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA M MUSIC Director Provider Enrollment 877-892-9815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207N00000X Dermatology |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 207VG0400X Obstetrics & Gynecology, Gynecology | |
| 207W00000X Ophthalmology | |
| 207X00000X Orthopaedic Surgery | |
| 208600000X Surgery | |
| 2086S0105X Surgery, Surgery of the Hand | |
| 2086S0129X | |
| 208D00000X General Practice | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2025-07-09 |