| NPI | 1104383322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED SADEK Owner 304-617-7140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| Enumeration Date | 2019-02-24 |
| Last Update Date | 2020-01-17 |