| NPI | 1790233401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOSONDRA GRANT Medical Billing Manager 770-485-1447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2016-09-12 |