| NPI | 1598242778 |
|---|---|
| Doing Business As | MIDC |
| Entity Type | Organization |
| Authorized Contact | RUSSELL M PETRAK Managing Partner 888-220-6432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2021-07-15 |