| NPI | 1336196856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR HUNT Administrator 251-867-6071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 208000000X Pediatrics | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| Enumeration Date | 2006-05-29 |
| Last Update Date | 2011-07-01 |