| NPI | 1548440407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY RUSSELL HASTINGS Owner/Physician 252-754-8370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 9800894) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NC 9800894) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2010-10-29 |