| NPI | 1386282838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RUSSELL FLEMING Owner 803-905-2273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2019-12-16 |