| NPI | 1851540785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT C COOLIDGE Agent 386-774-5211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: FL ME36924) |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2008-09-16 |