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Individual

THOMAS JUDE UNGARINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
804 13TH AVENUE, ALBANY, GA 31701
(229) 438-5864
(229) 438-1004
Mailing address
PO BOX 72105, ALBANY, GA 31708-2105
(229) 438-5864
(229) 438-1004

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
043799
GA
207RP1001X
Pulmonary Disease Physician
043799
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00761362A
GA
01
29000009849
RR MEDICARE
GA
01
52545954001
STATE MERIT
GA
01
545954
BCBS
GA
Enumeration date
04/26/2006
Last updated
10/30/2015
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