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1841920071
BRENDAN ALEXANDER MICCIO
AUGUSTA, GA
NPI
1841920071
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: GA 13813)
Enumeration Date
2022-06-11
Last Update Date
2022-06-11
Business Address
BRENDAN ALEXANDER MICCIO DO
1120 15TH ST
AUGUSTA, GA 30912-0004
Phone number: 706-721-4951
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Mailing Address
BRENDAN ALEXANDER MICCIO DO
3315 OAKRIDGE DR
AUGUSTA, GA 30909-2437
Phone number: 201-675-2559
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