| NPI | 1598126781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTAE RENEE LOCKHART Credential Admin 910-483-7337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 200101222) |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2021-08-27 |