NPI | 1003057696 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN WALLACE FERGUSON President 252-332-6484 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 36700) |
Enumeration Date | 2009-03-12 |
Last Update Date | 2009-03-12 |