Individual
DR. LARRY HORESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4750 WATERS AVE, SUITE 500, SAVANNAH, GA 31404-6200
(912) 352-8346
(912) 355-1414
Mailing address
PO BOX 116336, ATLANTA, GA 30368-6336
(912) 352-8346
(912) 352-1414
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
057481
GA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
057481
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308543732A
—
GA
05
—
308543732D
—
GA
05
—
3852310
—
TN
01
—
7124808
AETNA PPO PROVIDER ID
GA
05
—
G57481
—
SC
Enumeration date
03/02/2006
Last updated
01/11/2023
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