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 |