| NPI | 1902203326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD JOHNSON Owner 803-786-0980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2014-12-01 |