| NPI | 1265320055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MILLER CFO 678-967-5599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-06-27 |
| Last Update Date | 2025-07-28 |