# ST. MARY'S MEDICAL GROUP, INC.

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

## Provider details

- **NPI number:** 1891069290
- **Authorized official:** D. MONTEZ CARTER (PRESIDENT & CEO)
- **Authorized official phone:** (706) 389-3930

## Contact information

- **Practice address:** 1000 COWLES CLINC WAY, SUITE D-300, GREENSBORO, GA 30642-5285
- **Practice address phone:** (762) 243-3860
- **Practice address fax:** (762) 243-3879
- **Mailing address:** 1000 COWLES CLINC WAY, SUITE D-300, GREENSBORO, GA 30642-5285
- **Mailing address phone:** (762) 243-3860
- **Mailing address fax:** (762) 243-3879

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 63440 | GA | Yes |

## Other

- **Enumeration date:** 03/02/2012
- **Last updated:** 04/03/2018