| NPI | 1043551468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRYL WALLACE Business Manager 770-977-5056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME 114239) |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2013-10-17 |