NPI | 1124752886 |
---|---|
Entity Type | Organization |
Authorized Contact | DIANA REEDER Practice Administrator 470-589-7120 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist |
Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
Enumeration Date | 2022-07-10 |
Last Update Date | 2023-04-24 |