| NPI | 1497094205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYA S CULLINS Vice President 336-268-6469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 25937) |
| Enumeration Date | 2013-02-14 |
| Last Update Date | 2018-08-17 |