Organization
EAST GEORGIA INTERNAL MEDICINE ,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLADAPO O FAWIBE M.D. (DIRECTOR)
(706) 736-4154
Entity
Organization
Contact information
Practice address
811 13TH ST, SUITE 11, AUGUSTA, GA 30901-2700
(706) 736-4154
(706) 736-4155
Mailing address
PO BOX 3407, AUGUSTA, GA 30914-3407
(706) 736-4154
(706) 736-4155
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/30/2006
Last updated
08/22/2020
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