| NPI | 1780624627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH SKIDMORE Administrator 757-623-0005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2022-01-20 |