| NPI | 1427125269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ALLEN RIDDICK Practice Manager 919-734-4736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 38877) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2024-01-25 |