| NPI | 1255364600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SCOTT FENSTER Managing Partner 229-391-9980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 057762) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |