Organization
SUMTER PEDIATRICS LLC
Active
Other names
Sumter Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NELSON T MADRAZO MD (MANAGING MEMBER)
(229) 924-8082
Entity
Organization
Contact information
Practice address
151 GA HIGHWAY 27 E, AMERICUS, GA 31709-5249
(229) 924-8082
(229) 924-8009
Mailing address
151 GA HIGHWAY 27 E, AMERICUS, GA 31709-5249
(229) 924-8082
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363A00000X
Physician Assistant
004223
GA
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219934685A
—
GA
Enumeration date
11/13/2007
Last updated
01/19/2022
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