| NPI | 1588849327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA L MCLEMORE Credentialing Coordinator 704-323-2081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-01153) |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2007-12-28 |