| NPI | 1508459306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENIN J PETERS CEO 336-883-0029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2021-02-12 |