| NPI | 1083715023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L WALLACE Practice Administrator 336-714-3544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2012-10-12 |