| NPI | 1467451922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MARRERO Administrator 912-303-3552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207W00000X Ophthalmology | |
| 208000000X Pediatrics | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 225100000X Physical Therapist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 064752) | |
| 207RN0300X Internal Medicine, Nephrology (Licence: GA 047425) | |
| 207V00000X Obstetrics & Gynecology (Licence: GA 022482) | |
| 208600000X Surgery (Licence: GA 021614) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2022-07-21 |