Individual
KIMBERLY W MEGOW
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3526 NORTHCROSSING CIR, VALDOSTA, GA 31602-1067
(229) 241-9500
(229) 241-1047
Mailing address
3526 NORTHCROSSING CIR, VALDOSTA, GA 31602-1067
(229) 241-9500
(229) 241-1047
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
032494
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0048291A
—
GA
05
—
85002640G
—
GA
Enumeration date
05/31/2006
Last updated
07/09/2007
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