NPI | 1255688958 |
---|---|
Former Legal Business Name | PEDIATRIC ASSOCIATES, PC |
Entity Type | Organization |
Authorized Contact | SHANTAE RENEE LOCKHART Credentials Manager 910-483-7337 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics |
Enumeration Date | 2012-08-13 |
Last Update Date | 2021-08-27 |