| NPI | 1629018023 |
|---|---|
| Doing Business As | COLISEUM MEDICAL GROUP-NORTHSIDE |
| Entity Type | Organization |
| Authorized Contact | KRISTINE TURNER Controller 843-856-7938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2016-11-01 |