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Individual

DR. DAVID RONALD SQUIRES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3696 WHEELER RD, AUGUSTA, GA 30909-6520
(706) 736-1830
(706) 737-5103
Mailing address
3696 WHEELER RD, AUGUSTA, GA 30909-6520
(706) 736-1830
(706) 737-5103

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
052835
GA
207RH0003X
Hematology & Oncology Physician
Primary
052835
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004423
BLUE CROSS BLUE SHIELD
GA
01
604802700
UNITED HEALTHCARE
GA
05
851030536A
GA
05
G52835
SC
01
P00035368
RAILROAD MEDICARE
GA
Enumeration date
12/22/2005
Last updated
11/14/2024
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