| NPI | 1306957485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DELAC Administrator 703-650-2333 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 174400000X Specialist |
| 208C00000X Colon & Rectal Surgery | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-12-04 |