| NPI | 1992363758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN K. BURKETT Medical Director 919-250-3320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 103T00000X Psychologist | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2024-01-04 |