| NPI | 1982868642 |
|---|---|
| Doing Business As | PHS GENERAL SURGERY 104 |
| Entity Type | Organization |
| Authorized Contact | BEAU HIGGINBOTHAM Vice President/COO 410-368-3162 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: DC HFD01-0212) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2017-10-09 |