| NPI | 1811166549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA L DAVIS Billing Administrator 919-859-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 73992) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: NC 73992) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2011-09-16 |