| NPI | 1710732458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ROBERTS Medical Director 910-618-7139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-17 |