Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Diabetes Educator |
163WD0400X |
| NPI # | 1164092102 |
| LBN Legal business name | BAYCARE MEDICAL GROUP INC |
| Authorized official | LYNDA GORKEN - (VP,PFS) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/01/2021 |
| Last updated | 07/01/2021 - About 5 years ago |
| Identifiers | n/a |
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