Southeast Internal Medicine Pc

NPI 1104847607 - Internal Medicine - 207R00000X

NPI Details
NPI 1104847607
Enumeration Date 07/21/2006
Last Updated 06/05/2014
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name PAULINE M PAULINE
Position PHYSICIAN
Phone (912) 287-1555
Fax
Practice Location
406 RIVERSIDE DR
WAYCROSS GA, 31501-5315, US
Phone (912) 287-1555
Fax
Business Location
PO BOX 777
WAYCROSS GA, 31502-0777, US
Phone (912) 287-1555
Fax
Toxanomy
Taxonomy Code 207R00000X
License State
License Number
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According to our database, Southeast Internal Medicine Pc NPI is 1104847607, taxonomy code is 207R00000X Southeast Internal Medicine Pc physically located at 406 Riverside Dr, Waycross GA, 31501-5315. NPI Number 1033115704 has the healthcare provider type.

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1104847607 NPI number is provided on an as is basis without warranty of any kind. 1104847607 is maintained by the National Plan & Provider Enumeration System. The contents of Southeast Internal Medicine Pc are for informational purposes only.