| NPI | 1528557543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELINA HARSHA BISHOP Owner/Operator/Physician 704-664-1275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| 207Q00000X Family Medicine | |
| 207QB0002X Family Medicine, Bariatric Medicine | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine | |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2021-11-04 |