| NPI | 1770859266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS SMITH Chief Medical Officer 888-688-3628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 207R00000X Internal Medicine | |
| 207VG0400X Obstetrics & Gynecology, Gynecology | |
| 208000000X Pediatrics | |
| 208D00000X General Practice | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |