| NPI | 1003245838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY HERBERT FADIL Physician 251-295-2815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 29664) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2013-12-09 |