| NPI | 1770509309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOYD PUGH Administrator 251-304-0042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AL 8384) |
| Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: AL 27233) |
| 207R00000X Internal Medicine (Licence: AL 27233) | |
| 208000000X Pediatrics (Licence: AL 8384) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2007-10-24 |