Individual
MS. ALYCE M OLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, MD
Contact information
Practice address
1120 15TH ST, BI5083, AUGUSTA, GA 30912-0004
(706) 721-2981
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2602
(706) 828-8401
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
059298
GA
282N00000X
General Acute Care Hospital
059298
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52222473-001
GA BCBS
GA
05
—
575897337A
—
GA
05
—
G59298
—
SC
Enumeration date
07/22/2006
Last updated
11/07/2012
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