| NPI | 1659512531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANITA NETTLES Office Manager 910-904-6600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| 261QU0200X Clinic/Center, Urgent Care | |
| 363AM0700X Physician Assistant, Medical | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2009-03-23 |