| NPI | 1578629556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN PETTIS Executive Director 251-625-6896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology |
| Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology |
| 2085R0001X | |
| 208600000X Surgery | |
| 2086X0206X Surgery, Surgical Oncology | |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2024-05-20 |