| NPI | 1295918787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAHRAM FOROUZANDEH Owner 606-886-7471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2020-05-19 |