| NPI | 1376704155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BONLORE FERGUSON President/Owner 386-871-3767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME94793) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2013-03-04 |