Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatrics |
364SP0200X | 89 | Certified Clinical Nurse Specialist |
| NPI Number | 1700270436 |
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| LBN Legal business name | SUMMERSVILLE PEDIATRICS, INC. | ||||
| Authorized official | JOYCE MCCLUNG - (OFFICE MANAGER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 03/19/2015 | ||||
| Last updated | 03/19/2015 - About 11 years ago | ||||
| Identifiers |
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