| NPI | 1265645063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA M SWAFFORD Office Manager 770-704-9499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 047083) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 046761) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2010-06-30 |