| NPI | 1104124155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JOSEPH DEWAR Physician Assistant 336-790-0519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 200600668) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001000092) |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2011-04-13 |