Individual
COLVILLE H. FERDINAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3647 J DEWEY GRAY CIR STE 200, AUGUSTA, GA 30909-2205
(706) 504-9712
(706) 504-9703
Mailing address
PO BOX 3548, AUGUSTA, GA 30914-3548
(706) 863-9595
(706) 868-8375
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
53439
GA
2086S0102X
Surgical Critical Care Physician
Primary
53439
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10001269B
—
GA
05
—
G53439
—
SC
Enumeration date
08/30/2006
Last updated
10/08/2018
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