| NPI | 1093713695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS MICHAEL MAHAN CEO 919-693-7108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 25053) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 25053) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2014-09-15 |