| NPI | 1033389564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENISE NICOLE SHELTON Office Manager 678-705-2355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 050559) |
| Enumeration Date | 2008-03-12 |
| Last Update Date | 2016-12-27 |