Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic | |
Critical Care Medicine |
207RC0200X | 11 | Physician/Internal Medicine | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice | |
Internal Medicine |
207R00000X | 11 | Physician/Internal Medicine | |
Nurse Practitioner |
363L00000X | 50 | Nurse Practitioner | |
Pediatrics |
363LP0200X | 50 | Nurse Practitioner | |
Pediatrics |
208000000X | 37 | Physician/Pediatric Medicine | |
Pulmonary Disease |
207RP1001X | 11 | Physician/Internal Medicine |
| NPI # | 1508876863 |
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| LBN Legal business name | CHESTERFIELD-MARLBORO, LP | ||||||||||||
| Authorized official | LAURIE HOLTSFORD - (AUTHORIZED OFFICIAL) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 08/09/2006 | ||||||||||||
| Last updated | 01/21/2014 - About 12 years ago | ||||||||||||
| Identifiers |
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CHESTERFIELD-MARLBORO, LP
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