| NPI | 1346226024 |
|---|---|
| Doing Business As | NORTHEAST UROLOGY ASSOCIATES PA |
| Entity Type | Organization |
| Authorized Contact | CAMERON TRENT BLACKMAN Secretary Treasurer 704-786-5131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2020-08-22 |