SHADE RAYMOND PRESTON

AUGUSTA, GA
NPI1053431635
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: GA  058811)
Additional Taxonomies207LP2900X Anesthesiology, Pain Medicine
(Licence: GA  058811)
Enumeration Date2007-03-29
Last Update Date2008-06-16
Business Address
-- SHADE RAYMOND PRESTON D.O.
1350 WALTON WAY
AUGUSTA, GA 30901-2612
Phone number: 706-737-9250
Mailing Address
-- SHADE RAYMOND PRESTON D.O.
1824 WALTON WAY
AUGUSTA, GA 30904-3804
Phone number: 706-737-9250