| NPI | 1619935558 |
|---|---|
| Other Name | BONGO MEDICAL |
| Entity Type | Organization |
| Authorized Contact | LESLIE A. GLASGOW CEO 907-569-1049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2013-01-03 |