| NPI | 1144390626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY L CARAWAN Adminsitrator 757-934-3434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101036848) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2010-02-26 |