| NPI | 1598148801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNENA OXENDINE Credentialing Rep. 910-671-8766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2007-01953) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2011-00810) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2020-11-17 |