Individual
FRED A TEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 BAYNARD PARK, NEWNAN, GA 30265-6413
(770) 251-5253
(770) 251-5254
Mailing address
15A BAYNARD PARK, NEWNAN, GA 30265
(770) 251-5253
(770) 251-5254
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
056493
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
860284415G
—
GA
Enumeration date
05/24/2006
Last updated
02/09/2019
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