| NPI | 1609940105 |
|---|---|
| Doing Business As | EASTSIDE FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JIM SIEMERS Executive Director 765-362-2800 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2008-07-24 |