NPI Details | |
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NPI | 1104847607 |
Enumeration Date | 07/21/2006 |
Last Updated | 06/05/2014 |
Entity Type | Healthcare Provider |
Active | Over 11 years ago |
Authorized Information | |
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Name | PAULINE M PAULINE |
Position | PHYSICIAN |
Phone | (912) 287-1555 |
Fax |
Practice Location | |
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406 RIVERSIDE DR WAYCROSS GA, 31501-5315, US |
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Phone | (912) 287-1555 |
Fax |
Business Location | |
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PO BOX 777 WAYCROSS GA, 31502-0777, US |
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Phone | (912) 287-1555 |
Fax |
Toxanomy | |
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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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