Organization
MPPG, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMMY HASH (PROVIDER ENROLLMENT COORDINATOR)
(912) 350-9335
Entity
Organization
Contact information
Practice address
4731 WATERS AVE, SAVANNAH, GA 31404-6219
(912) 350-4905
(912) 350-4955
Mailing address
PO BOX 102032, ATLANTA, GA 30368-2032
(912) 350-4905
(912) 350-4955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
2080P0205X
Pediatric Endocrinology Physician
—
—
2080P0207X
Pediatric Hematology & Oncology Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208600000X
Surgery Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300031676A
—
GA
Enumeration date
07/25/2006
Last updated
05/10/2017
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