| NPI | 1861019663 |
|---|---|
| Doing Business As | SSM HEALTH MEDICAL GROUP UROGYNOCOLOGY |
| Entity Type | Organization |
| Authorized Contact | CRYSTAL L PENA Provider Enrollment Coordinator 405-272-7452 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2088F0040X Urology, Female Pelvic Medicine and Reconstructive Surgery |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Enumeration Date | 2020-06-29 |
| Last Update Date | 2020-06-29 |