| NPI | 1124733480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER MARK VANRAAM COO 205-703-6760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2024-03-07 |