| NPI | 1437352796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELTON ANDERSON Md 540-389-3620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: DC 20985) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0041182) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2008-01-23 |