| NPI | 1821424789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE NEWSOM Owner 877-866-7123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2021-10-12 |