| NPI | 1447339767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAZETT SHIVERS Administrator 252-758-8181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Additional Taxonomies | 174400000X Specialist |
| 174400000X Specialist | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-05 |