Prime Healthcare Services-St Michaels Medical Group LLC

NPI #1326494378 in Newark, New Jersey

Provider Information

NPI Number: 1326494378
Entity Type: Organization
Organization Name: Prime Healthcare Services-St Michaels Medical Group LLC
Primary Specialty: Internal Medicine
Enumeration Date: May 9, 2016
Last Updated: May 12, 2016

Practice Location

Address: 111 CENTRAL AVE
City: Newark
State: New Jersey
ZIP Code: 07102-1909
Phone: (973) 854-3592

Authorized Official

Name: CHRISTOPHER DOAN
Title: CHIEF COMPLIANCE COUNSEL
Phone: (909) 235-4307

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X
Psychiatry & Neurology - Psychiatry — Psychiatry	2084P0800X
Surgery	208600000X
Podiatrist	213E00000X
Internal Medicine	207R00000X	Primary

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