| NPI | 1154676096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEBRAHTOM WOLDU TESFAI Md 336-394-6045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WV 23729) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |