Organization
NORTHSIDE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERT A TITUS M.D. (OWNER)
(340) 772-2000
Entity
Organization
Contact information
Practice address
252 ESTATE GLYNN, AGAPE MEDICAL CENTER, KINGSHILL, VI 00850-9826
(340) 772-2000
Mailing address
252 ESTATE GLYNN, AGAPE MEDICAL CENTER, KINGSHILL, VI 00850-9826
(340) 772-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1631
VI
Other
Enumeration date
02/15/2012
Last updated
02/15/2012
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