| NPI | 1023517505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J ALPHONSO DANDY CEO 912-927-8011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246XC2903X Spec/Tech, Cardiovascular, Vascular Specialist |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2018-02-09 |