| NPI | 1104195999 |
|---|---|
| Doing Business As | SANDHILLS MEDICAL GROUP WEST MAIN |
| Entity Type | Organization |
| Authorized Contact | MICHAEL L GINGRAS Vice President 239-598-3131 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2012-11-28 |