Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral & Maxillofacial Surgery |
204E00000X | 02 | Physician/General Surgery | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company |
| NPI Number | 1174732572 |
| LBN Legal business name | BAYCARE CLINIC LLP |
| Authorized official | CHRIS AUGUSTINE - (CHIEF EXECUTIVE OFFICER) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 05/22/2007 |
| Last updated | 04/13/2022 - About 4 years ago |
| Identifiers | n/a |
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