| NPI | 1376635276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN KABZEEL YESUDAS CHACKO President Owner 757-399-0886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery |
| Additional Taxonomies | 208600000X Surgery |
| 2086S0129X | |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2025-09-11 |