| NPI | 1578656773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA FLORENCE MARCUSSEN CEO 910-343-0811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: NC CERTIFICATE # 40958) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC CERTIFICATE # 40958) |
| 208600000X Surgery (Licence: NC 40958) | |
| 2086S0129X Surgery Vascular Surgery (Licence: NC 40958) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-04-25 |