| NPI | 1932206125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID R. FULP President 757-312-6585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101056073) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2010-11-19 |