Organization
AUGUSTA PRIMARY CARE SERVICES, LLC
Active
Other names
Augusta Health Spec-Urology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRAKASH MANIAM M.D. (PROVIDER)
(706) 922-7670
Entity
Organization
Contact information
Practice address
3623 J DEWEY GRAY CIR, SUITE 210, AUGUSTA, GA 30909-6511
(706) 922-7670
(706) 922-7680
Mailing address
3623 J DEWEY GRAY CIR, SUITE 210, AUGUSTA, GA 30909-6511
(706) 922-7670
(706) 922-7680
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
27620
SC
Other
Enumeration date
09/26/2007
Last updated
06/25/2013
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