| NPI | 1962773515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLTON REID BEAMAN Physician Assistant 252-439-0065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NC 101911) |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-01-13 |