| NPI | 1861034779 |
|---|---|
| Doing Business As | SSM HEALTH MEDICAL GROUP SEMINOLE |
| Entity Type | Organization |
| Authorized Contact | CRYSTAL L PENA Provider Enrollment/Ins Credential 405-272-7452 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-10-11 |
| Last Update Date | 2019-10-11 |