| NPI | 1255192308 |
|---|---|
| Doing Business As | HIGH TIDE INTERNAL MEDICINE - EAST COOPER MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DOREATHA ROGERS Rcs Manager 980-302-7992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2024-01-17 |
| Last Update Date | 2024-01-22 |