| NPI | 1609530013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA REEP Billing Manager 888-307-2425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2025-10-16 |