| NPI | 1669531505 |
|---|---|
| Doing Business As | MEMORIAL-SCAD CENTER FOR HEALTH |
| Entity Type | Organization |
| Authorized Contact | ROBIN J. MADDOX Provider Enrollment Coordinator 912-350-9335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2014-11-21 |