Individual
SHILPA A REGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-AA
Contact information
Practice address
380 HOSPITAL DR, SUITE 410, MACON, GA 31217
(478) 746-5644
Mailing address
PO BOX 2564, MACON, GA 31203-2565
(478) 746-5644
(478) 745-4849
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
006302
GA
367H00000X
Anesthesiologist Assistant
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003115954A
—
GA
05
—
003115954B
—
GA
05
—
003115954C
—
GA
05
—
003115954D
—
GA
01
—
580628385
TRICARE
GA
01
—
636689
WELLCARE
GA
Enumeration date
10/26/2011
Last updated
09/09/2013
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