| NPI | 1093731671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN SIMON Practice Administrator 336-621-8911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 39624) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NC 39624) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2019-07-24 |