Organization
HOUSE CALLS OF COASTAL GEORGIA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISMAEL SALIM OSTA PA-C (MANAGER)
(912) 581-6913
Entity
Organization
Contact information
Practice address
811 SAND DOLLAR TRCE, ST SIMONS ISLAND, GA 31522-3761
(912) 580-6913
(912) 265-2859
Mailing address
811 SAND DOLLAR TRCE, ST SIMONS ISLAND, GA 31522-3761
(912) 580-6913
(912) 265-1212
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15631
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00069297A3
—
GA
05
—
021787368C
—
GA
Enumeration date
01/21/2013
Last updated
09/19/2013
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