| NPI | 1184964967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH STEWART Practice Administrator 770-469-0668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 041369) |
| Enumeration Date | 2013-02-15 |
| Last Update Date | 2013-05-14 |