| NPI | 1689719767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Director Of Provider Enrollment 877-892-9813 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 207RI0011X Internal Medicine, Interventional Cardiology | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2007-10-08 |