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Organization

COASTAL MEDICAL SPECIALISTS IN LUNG & CRITICAL CARE, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ADEWUMI O OGUNTUMIBI M.D. (CEO/MD)
(912) 354-7679
Entity
Organization

Contact information

Practice address
411 STEPHENSON AVE, SAVANNAH, GA 31405-5968
(912) 354-7679
(912) 354-4018
Mailing address
411 STEPHENSON AVE, SAVANNAH, GA 31405-5968
(912) 354-7679
(912) 354-4018

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
049393
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000900798I
GA
05
000900798M
GA
05
00900797H
GA
05
00900798C
GA
05
00900798D
GA
05
00900798E
GA
05
00900798F
GA
05
00900798G
GA
05
00900798H
GA
05
85003028G
GA
01
930105831
RAILROAD MEDICARE
GA
Enumeration date
04/12/2007
Last updated
12/03/2013
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