| NPI | 1376527077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABBY CONDRA Credentialing Coordinator 706-243-4506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: GA 046075) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2018-03-17 |