| NPI | 1962593574 |
|---|---|
| Doing Business As | BLUEWATER MEDICINE |
| Entity Type | Organization |
| Authorized Contact | KENNETH WAYNE PONDER President 850-517-7877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0063310) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2021-12-29 |