| NPI | 1639339252 |
|---|---|
| Doing Business As | MHUP - EISENHOWER MEDICAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | ROBIN J. MADDOX Provider Enrollment Coordinator 912-350-9335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2008-06-17 |
| Last Update Date | 2011-06-01 |