Graduated: 2000
NPI: 1336344977
Practice Locations (2)
VIDANT MEDICAL GROUP LLC
521 MOYE BLVD C
GREENVILLE, NC 278342849
2527441440
NORTH CAROLINA MG LLC
4420 LAKE BOONE TRL
RALEIGH, NC 276077505
9842154000
Source: CMS National Downloadable File, September 2026.