| NPI | 1275008351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEEMAL SHAH CEO 706-951-8657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 208800000X Urology |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2025-01-07 |