| NPI | 1053776120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP G MONDI Physician 910-235-3195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NC 9601769) |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2015-12-16 |