NPI | 1518746460 |
---|---|
Former Legal Business Name | INDEPENDENT MEDICAL GROUP, LLC |
Entity Type | Organization |
Authorized Contact | STEVE VIXAMAR CEO 800-773-7066 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
Enumeration Date | 2023-09-28 |
Last Update Date | 2025-05-14 |