| NPI | 1700914066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN M. DEMICCO Owner 912-920-8898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: GA 029804) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |