NPI | 1619850559 |
---|---|
Doing Business As | MVMG 4150 WOODMEN ROAD |
Entity Type | Organization |
Authorized Contact | TRACEY J BAUGHEY Director Of Credentialing 267-981-6519 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
208000000X Pediatrics | |
Enumeration Date | 2025-07-29 |
Last Update Date | 2025-07-29 |