| NPI | 1972791200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE K ALBERT Business Manager 803-779-0819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: SC 13344) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2007-10-15 |