| NPI | 1932421187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLIE C ROUSE Physician 770-838-8443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: GA 044076) |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2018-11-22 |