| NPI | 1073775904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SHANE BUSMAN M.D. 229-924-2383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: GA 040628) |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2008-07-01 |