| NPI | 1629405550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN SMITH Credentialing COO Rdinator 919-342-6842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2011-01123) |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2013-10-10 |