| NPI | 1538292123 |
|---|---|
| Doing Business As | MAIN STREET PHYSICIANS |
| Entity Type | Organization |
| Authorized Contact | ANGELA FUTRELL Chief Executive Officer 757-925-1866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2012-11-01 |