| NPI | 1194267336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEKITA CLYBURN Billing Administration 336-790-9787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 39460) |
| Additional Taxonomies | 251S00000X |
| 207R00000X Internal Medicine (Licence: NC 39460) | |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2019-08-06 |