| NPI | 1013002138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ANDERSON FAGG President 336-765-8620 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NC 200001376220) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NC 200001355455) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NC 200001349669) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-08-01 |