NPI | 1336422302 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL SUE Physician/Owner 252-335-4619 |
Organization Subpart ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NC 9600169) |
Additional Taxonomies | 174400000X Specialist (Licence: NC 151718) |
Enumeration Date | 2011-09-26 |
Last Update Date | 2011-10-22 |