Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Diabetes Educator |
163WD0400X |
| NPI Number | 1376995175 |
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| LBN Legal business name | PHYSICIANS MEDICAL CENTER, P C | ||||
| Authorized official | DENNIS GRAY - (ADMINISTRATOR) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 07/06/2016 | ||||
| Last updated | 09/12/2022 - About 4 years ago | ||||
| Identifiers |
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PHYSICIANS MEDICAL CENTER, P C
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