Individual
SAMIR MEWAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 MANCHESTER EXPY STE 1001, BUTLER PAVILION, COLUMBUS, GA 31904-6802
(706) 322-0528
(706) 322-2080
Mailing address
2300 MANCHESTER EXPY STE 1001, BUTLER PAVILION, COLUMBUS, GA 31904-6802
(706) 322-0528
(706) 322-2080
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
049064
GA
174400000X
Specialist
23490
AL
207RC0000X
Cardiovascular Disease Physician
049064
GA
207RI0011X
Interventional Cardiology Physician
049064
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00878193A
—
GA
01
—
009985570
ALABAMA MEDICAID
AL
01
—
060062938
RAILROAD MEDICARE
GA
01
—
814579
BCBS PROVIDER NUMBER
GA
01
—
8566805-001
CIGNA PROVIDER NUMBER
—
Enumeration date
09/04/2006
Last updated
10/15/2013
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