| NPI | 1285066233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE M. ALEXANDER Credentialing 803-773-5227 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 25856) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2013-10-02 |