Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Student Health |
261QS1000X | |||
Diagnostic Radiology |
2085R0202X | 30 | Physician/Diagnostic Radiology | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice | |
Occupational Medicine |
2083X0100X | 84 | Physician/Preventive Medicine | |
Public Health & General Preventive Medicine |
2083P0901X | 84 | Physician/Preventive Medicine |
| NPI # | 1174803027 |
| LBN Legal business name | HEALTH AND EDUCATION BUILDING |
| Authorized official | ANDREA RUMBLE - (PROVIDER ENROLLMENT SPECIALIST) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 08/24/2011 |
| Last updated | 05/22/2014 - About 12 years ago |
| Identifiers | n/a |
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HEALTH AND EDUCATION BUILDING
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