| NPI | 1891908422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEWART CLEAVES MANNING Doctor 252-338-2144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 38380) |
| Additional Taxonomies | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: NC 38380) |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2022-07-21 |