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Individual

SALLIE S BATEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA/AA

Contact information

Practice address
380 HOSPITAL DR, SUITE 410, MACON, GA 31217
(478) 746-5644
(478) 745-4849
Mailing address
PO BOX 2564, MACON, GA 31203
(478) 746-5644
(478) 745-4849

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
004333
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
326281
WELLCARE
GA
05
417581048B
GA
05
417581048C
GA
05
417581048D
GA
05
417581048E
GA
01
P00212669
RAILROAD MEDICARE
GA
Enumeration date
08/04/2006
Last updated
06/04/2013
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