| NPI | 1407045628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY E. SMITH Physician Assistant / Administrativ 910-522-7185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 145009) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 145009) |
| 363A00000X Physician Assistant (Licence: NC 103971) | |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2010-03-30 |