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Organization
MPPG, INC.
Active
Organization
MPPG, INC.
Active
Other names
Savannah Vascular Surgery, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR)
(912) 350-9335
Entity
Organization
Contact information
Practice address
4750 WATERS AVE, SUITE 500, SAVANNAH, GA 31404-6200
(912) 350-5961
(912) 350-5942
Mailing address
PO BOX 102032, ATLANTA, GA 30368-2032
(912) 350-5961
(912) 350-5942
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
—
NULL
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
11/29/2006
Last updated
06/01/2011
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