| NPI | 1679913651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SATYA JAMMALAMADAKA Md 704-540-3036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NC 201001747) |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2013-07-05 |