Organization
METRO SURGICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUE PAYNE (PRACTICE MANAGER)
(912) 826-4057
Entity
Organization
Contact information
Practice address
12 ARLEY WAY, STE 103B, BLUFFTON, SC 29910-8860
(912) 826-4057
(912) 826-2853
Mailing address
PO BOX 919, RINCON, GA 31326-0919
(912) 826-4057
(912) 826-2853
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
043557
GA
174400000X
Specialist
MD26551
SC
208600000X
Surgery Physician
Primary
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00791557A
—
GA
05
—
055003099A
—
GA
01
—
CN8505
RR CARE
GA
05
—
GPA720
—
SC
Enumeration date
01/30/2012
Last updated
07/06/2021
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