| NPI | 1861602500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD MICHAEL MATUSHIN Physician 605-229-2544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SD 3575) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-10-03 |