NPI | 1528557543 |
---|---|
Entity Type | Organization |
Authorized Contact | DELINA HARSHA BISHOP Owner/Operator/Physician 704-664-1275 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
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 |