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General NPI Number Information
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NPI Number | 1194591750
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Entity Type | Organization
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Legal Business Name | ENDOLINK CLINIC LLC
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Dates
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Enumeration Date | 11/27/2023
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 103 SAUNTON LINKS
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-7471
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Country | US
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Telephone | 832-648-0468
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Fax |
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Provider Business Mailing Address
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Address Line | 103 SAUNTON LINKS
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-7471
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Country | US
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Telephone | 832-648-0468
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ABEL YIMER
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Credential | MD
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Telephone | 832-648-0468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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