| NPI | 1215385463 |
|---|---|
| Doing Business As | PREMIUM DIRECT MEDICAL |
| Entity Type | Organization |
| Authorized Contact | SHAWANDA LESTER SPENCER Managing Director/Head Np 704-907-0537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC F0516317) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2016-05-27 |