| NPI | 1144760927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN RICHMOND Operations Manager 843-631-4656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2017-07-24 |