Graduated: 2010
NPI: 1629363122
Practice Locations (2)
SOUTHEASTERN INTEGRATED CARE
105 FARM BROOK DR
LUMBERTON, NC 283582179
9107387789
NORTH CAROLINA MG LLC
4420 LAKE BOONE TRL
RALEIGH, NC 276077505
9842154000
Source: CMS National Downloadable File, September 2026.