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A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adolescent Medicine |
207QA0000X | 08 | Physician/Family Practice |
| NPI # | 1962712521 |
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| LBN Legal business name | CHILDREN'S HOSPITAL MEDICAL PRACTICE CORPORATION | ||||||||
| Authorized official | MATT GRONINGER - (EXECUTIVE DIRECTOR) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | Yes | ||||||||
| Enumeration date | 10/18/2010 | ||||||||
| Last updated | 05/10/2018 - About 8 years ago | ||||||||
| Identifiers |
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CHILDREN'S HOSPITAL MEDICAL PRACTICE CORPORATION