| NPI | 1235415696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY CAMMACK Practice Manager 678-551-7810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 036281) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2011-10-31 |