| NPI Details | |
|---|---|
| NPI | 1104847607 |
| Enumeration Date | 07/21/2006 |
| Last Updated | 06/05/2014 |
| Entity Type | Healthcare Provider |
| Active | Over 11 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 | |
| Remove 1104847607 NPI Number | |
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.
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