Promed Preferred Wi Sc
Family Medicine in Hudson, WI. Organization (NPI-2).
NPI number1013735802
StatusActive
Last updated in NPPESSep 30, 2024
Details
- NPI
- 1013735802
- Entity type
- Organization (NPI-2)
- Legal business name
- Promed Preferred Wi Sc
- Organization subpart
- No
- Enumeration date
- Sep 30, 2024
- Certification date
- Sep 30, 2024
- Last updated
- Sep 30, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
155 2nd St SHudson, WI 54016-2234
Phone 615-499-3165
Mailing address
329 S Oyster Bay Rd Ste 2059Plainview, NY 11803-3301
Authorized official
Lev Grinman
Owner
6154993165
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All 34 Family Medicine Physician providers in Hudson · All 857 providers in Hudson
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