| NPI | 1942343884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEODORO G MEDINA President 304-842-5449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2007-11-20 |