| NPI | 1376156620 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JON ERIC WELCH Owner/Provider 704-754-0257 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology | 
| Enumeration Date | 2020-08-26 | 
| Last Update Date | 2020-12-04 |