Organization
MARSHES MEDICAL DIAGNOSTIC CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANDREA PAGE CALLAHAN (SEC/TREAS)
(912) 264-6133
Entity
Organization
Contact information
Practice address
2705 WILDWOOD DR, BRUNSWICK, GA 31520-4346
(912) 264-6133
(912) 267-1415
Mailing address
2705 WILDWOOD DR, BRUNSWICK, GA 31520-4346
(912) 264-6133
(912) 267-1415
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CL1232
RAILROAD MEDICARE
GA
01
—
GRP 1465
CAHABA MEDICARE
GA
Enumeration date
07/30/2006
Last updated
06/01/2009
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