| NPI | 1487228425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS FORDHAM BREWER Provider 251-450-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine |
| 2083X0100X Preventive Medicine, Occupational Medicine | |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2021-07-27 |