| NPI | 1003123381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CHARLES HERRING Shareholder 336-998-3833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: NC 2010-00510) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NC 2010-00510) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2010-09-08 |