Individual
DR. MICHAEL ANDREW REGISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3689 WILMA EDWARDS RD, ELLABELL, GA 31308-5315
(912) 653-4357
(912) 653-4320
Mailing address
PO BOX 1047, ELLABELL, GA 31308-1047
(912) 653-4357
(912) 653-4320
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
026924
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288582981A
—
GA
Enumeration date
01/17/2007
Last updated
01/13/2021
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