Individual
DR. MAURICE M SOLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2409 N PATTERSON ST, SUITE 230, VALDOSTA, GA 31602-2512
(229) 259-4369
(229) 433-6513
Mailing address
2409 N PATTERSON ST, SUITE 230, VALDOSTA, GA 31602-2512
(229) 259-4369
(229) 433-6513
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
030673
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00366528D
—
GA
01
—
083704148
TRICARE
GA
01
—
52027849
BLUE CROSS
GA
01
—
770002707
RAIL ROAD
GA
Enumeration date
06/06/2006
Last updated
09/09/2014
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