| NPI | 1669989422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON SELENA DUNCAN Credentialing Specialist 678-656-7203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 72065) |
| Enumeration Date | 2018-01-02 |
| Last Update Date | 2018-01-02 |