| NPI | 1184952707 |
|---|---|
| Doing Business As | SOUTHSIDE INTERNAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | ASHLEIGH A RAUBENOLT Credentialing 540-371-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102037027) |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2009-11-19 |