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Organization
MPPG, INC.
Active
Organization
MPPG, INC.
Active
Other names
Memorial Health Savannah Mall
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR)
(912) 350-9335
Entity
Organization
Contact information
Practice address
14089 ABERCORN STREET, SAVANNAH, GA 31419
(912) 350-2138
(912) 350-2145
Mailing address
PO BOX 102032, ATLANTA, GA 30368-2032
(912) 350-2138
(912) 350-2145
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
12/08/2006
Last updated
06/01/2011
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