Individual
DOUGLAS E MCNIECE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
501 REDMOND RD NW, ANESTHESIOLOGY DEPARTMENT, ROME, GA 30165-1415
(706) 291-0291
Mailing address
19 WESTOVER DR SW, ROME, GA 30165-3453
(706) 295-9342
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
001706
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100001196B
—
GA
05
—
100001196C
—
GA
01
—
P00211519
RAILROAD MEDICARE
GA
Enumeration date
05/26/2006
Last updated
09/29/2011
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