| NPI | 1699180315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES BUCKMASTER M.D. 251-955-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AL 20768) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: AL 1-131772) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-06-23 |