| NPI | 1427487099 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JOHN SMITH Credentialing COO Rdinator 919-342-6842  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NC 2010-00095)  | 
| Enumeration Date | 2013-11-05 | 
| Last Update Date | 2023-08-14 |