| NPI | 1205841616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY MICHAEL PITTMAN President 919-846-7403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NC 40818) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-22 |