Facts
- Status
- A
- Credential
- M.D.
- Type
- Individual
- Enumeration date
- 2006-06-26
- Last updated
- 2022-09-13
Specialties
Licenses
- License SC
- 23810
- License GA
- 052664
Location
- Practice location
- 4750 WATERS AVE, SUITE 500
- City
- SAVANNAH GA
- Postal code
- 31404
- Phone
- 866-957-8346
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
Search this city from the state hub for other records in the public registry.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.