NPI | 1629745039 |
---|---|
Entity Type | Organization |
Authorized Contact | SOUJANYA PULLURU Owner Mc Medical LLC 479-204-1258 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 103T00000X Psychologist |
104100000X Social Worker | |
231H00000X Audiologist | |
363L00000X Nurse Practitioner | |
Enumeration Date | 2021-08-24 |
Last Update Date | 2023-04-04 |