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Organization
SOUTHCOAST MEDICAL GROUP, LLC
Active
Organization
SOUTHCOAST MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MARRERO (ADMINISTRATOR)
(912) 303-3552
Entity
Organization
Contact information
Practice address
330 BENEFIELD DR, SAVANNAH, GA 31406-2604
(912) 303-3552
(912) 303-3506
Mailing address
PO BOX 15849, SAVANNAH, GA 31416-2549
(912) 303-3552
(912) 303-3506
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
GA
207R00000X
Internal Medicine Physician
—
GA
207RC0000X
Cardiovascular Disease Physician
—
GA
207RI0200X
Infectious Disease Physician
—
GA
207RN0300X
Nephrology Physician
047425
GA
207RP1001X
Pulmonary Disease Physician
—
GA
207V00000X
Obstetrics & Gynecology Physician
022482
GA
207W00000X
Ophthalmology Physician
—
GA
208000000X
Pediatrics Physician
—
GA
2084N0400X
Neurology Physician
064752
GA
2085R0202X
Diagnostic Radiology Physician
—
GA
208600000X
Surgery Physician
021614
GA
225100000X
Physical Therapist
—
GA
363A00000X
Physician Assistant
—
GA
363L00000X
Nurse Practitioner
—
GA
Other
Enumeration date
07/18/2005
Last updated
07/21/2022
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