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Individual

DR. HUMBERTO SIFUENTES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2238
(706) 721-0331
Mailing address
1499 WALTON WAY, SUITE 1400, AUGUSTA, GA 30901-2602
(706) 721-2238
(706) 721-0331

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-121980
IL
207RG0100X
Gastroenterology Physician
Primary
066071
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
066071
GA LICENSES
GA
Enumeration date
08/05/2008
Last updated
03/07/2023
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