NPI | 1205631108 |
---|---|
Entity Type | Organization |
Authorized Contact | KARA RICHARDSON VP Managed Health 704-631-0450 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207R00000X Internal Medicine |
208000000X Pediatrics | |
Enumeration Date | 2025-02-14 |
Last Update Date | 2025-02-14 |