Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI # | 1619322781 |
| LBN Legal business name | AM SURGICAL ASSIST |
| Authorized official | AMY MAUTNER - (SURGICAL ASSISTANT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 04/26/2016 |
| Last updated | 06/23/2020 - About 6 years ago |
| Identifiers | n/a |
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