| NPI | 1316480049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJA PALADUGU Medical Director 864-436-1021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 19254) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 19705) |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2016-11-29 |