Organization
SATILLA FAMILY MEDICINE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUKESH AGARWAL M.D. (SECRETARY/TREASURER)
(912) 338-0065
Entity
Organization
Contact information
Practice address
407 W ONEIDA ST, WAYCROSS, GA 31501-5320
(912) 338-0065
(912) 338-0920
Mailing address
407 W ONEIDA ST, WAYCROSS, GA 31501-5320
(912) 338-0065
(912) 338-0920
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
048327
GA
207R00000X
Internal Medicine Physician
Primary
039994
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085002995G
—
GA
Enumeration date
06/19/2006
Last updated
10/15/2009
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