Individual
DAVID KAVTARADZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
902 N 7TH ST, CORDELE, GA 31015-3234
(229) 276-3100
Mailing address
1008 N 7TH STREET, CORDELE, GA 31015
(229) 271-4608
(229) 271-4609
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
051148
GA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
051148
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000976214A
—
GA
Enumeration date
02/09/2006
Last updated
02/26/2021
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