# SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689998536
- **Authorized official:** MARIA MASCOLO III M.D. (PARTNER)
- **Authorized official phone:** (912) 354-6614

## Contact information

- **Practice address:** 209C MIMS RD, SYLVANIA, GA 30467-1994
- **Practice address phone:** (912) 564-5977
- **Practice address fax:** (912) 564-1259
- **Mailing address:** 340 EISENHOWER DR, BUILDING \#1500, SAVANNAH, GA 31406-1600
- **Mailing address phone:** (912) 354-6614
- **Mailing address fax:** (912) 356-9078

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RP1001X | Pulmonary Disease Physician | 052469 | GA | Yes |

## Other

- **Enumeration date:** 03/22/2010
- **Last updated:** 03/22/2010