| NPI | 1578384301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM THOMAS BUNTING Practice Manager 252-341-3320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2026-06-05 |