Individual
CYNTHIA ANN DOALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
900 MOHAWK ST, SAVANNAH, GA 31419-1780
(912) 925-0067
(912) 927-0267
Mailing address
900 MOHAWK ST, SAVANNAH, GA 31419-1780
(912) 925-0067
(912) 927-0267
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
003750
GA
207NP0225X
Pediatric Dermatology Physician
003750
GA
207NS0135X
Procedural Dermatology Physician
003750
GA
363A00000X
Physician Assistant
Primary
003750
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002291A
—
GA
05
—
451661273A
—
GA
05
—
451661273B
—
GA
05
—
451661273C
—
GA
01
—
970025786
RAILROAD MEDICARE NUMBER
GA
Enumeration date
04/25/2006
Last updated
02/01/2012
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