| NPI | 1942917380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHANI MOHAN VUPADHYAYULA Member 704-813-7476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2022-11-04 |
| Last Update Date | 2024-08-29 |