Organization
CATHERINE BOMBERGER, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE BOMBERGER MD (OWNER)
(478) 464-1933
Entity
Organization
Contact information
Practice address
310 HOSPITAL DR, BLDG B, SUITE 315, MACON, GA 31217-3895
(478) 464-1933
(478) 464-5094
Mailing address
310 HOSPITAL DR, BLDG B, SUITE 315, MACON, GA 31217-3895
(478) 464-1933
(478) 464-5094
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
048188
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00875476A
—
GA
01
—
11BDRTP
MEDICARE PTAN
GA
Enumeration date
10/11/2012
Last updated
10/11/2012
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