| NPI | 1982615282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN HALM Practice Administrator 336-634-3902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2008-10-13 |