| NPI | 1740691674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EARL EUGENE BAIN Owner/Physician 919-518-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NC 2013-02484) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2014-09-19 |