A physician engaged in the subspecialty practice of Addiction Medicine who specializes in the prevention, evaluation, diagnosis, treatment, and recovery of persons with the disease of addiction.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction Medicine |
2083A0300X | 84 | Physician/Preventive Medicine |
| NPI # | 1457971558 |
| LBN Legal business name | NEW HEALTH AND ANTI-AGING CLINIC LLC |
| Authorized official | LIZ SHEPHERD - (DIRECTOR OF CREDENTIALING) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 04/20/2020 |
| Last updated | 04/20/2020 - About 6 years ago |
| Identifiers | n/a |
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