| NPI | 1104812692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE E STROUD President 864-855-1036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 851) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: SC 8878) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: SC 9099) | |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2007-10-31 |