| NPI | 1851060289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOUJANYA PULLURU Owner Mc Medical LLC 479-204-1258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 231H00000X Audiologist |
| 363L00000X Nurse Practitioner | |
| 103T00000X Psychologist | |
| 104100000X Social Worker | |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2021-09-09 |