Individual
DR. SALOME EWURASI DEFORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2501 N PATTERSON ST, VALDOSTA, GA 31602-1735
(470) 316-3378
Mailing address
2501 N PATTERSON ST, VALDOSTA, GA 31602-1735
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
71541
TN
207R00000X
Internal Medicine Physician
Primary
88578
GA
208M00000X
Hospitalist Physician
88578
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2018
Last updated
05/08/2026
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