| NPI | 1720261266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA JADICK Credentialing 251-479-0058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AL 17868) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2025-06-25 |