| NPI | 1902991151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BONIFACE Managing Physician 540-371-9696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2014-01-30 |