| NPI | 1619938024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BENISH President 276-236-2947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101041026) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024103947) |
| 207Q00000X Family Medicine (Licence: VA 0101057515) | |
| 363A00000X Physician Assistant (Licence: VA 0110001464) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2008-03-03 |