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Organization
138 MED
NPI 1134635105
Active
Family Medicine
Quick Facts
NPI Number
1134635105
Type
Organization (NPI-2)
Status
Active
Enumeration Date
2017-12-28
Last Updated (NPPES)
2018-03-17
Primary Specialty / Taxonomy
| Taxonomy | Family Medicine |
| Taxonomy Code | 207Q00000X |
Data sourced live from the CMS NPPES NPI Registry (npiregistry.cms.hhs.gov) and cached locally. This is a public directory lookup, not a credentialing or verification service — confirm critical details directly with NPPES or the provider.