| NPI | 1609325653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY LEWTER Doctor 252-209-0489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: NC 814002694) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2016-09-30 |