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Individual

WILLIAM GREENE SUTLIVE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6555 ABERCORN ST STE 129, SAVANNAH, GA 31405-5723
(912) 341-6007
(912) 428-5621
Mailing address
6555 ABERCORN ST STE 129, SAVANNAH, GA 31405-5723
(912) 341-6007
(912) 428-5621

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
23235
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
87-0964385
TAX ID
GA
Enumeration date
10/29/2008
Last updated
05/23/2022
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