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Individual

JOEL MATTHIAS BIESTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1120 15TH STREET, AUGUSTA, GA 30912-0004
(706) 721-8623
(706) 721-1459
Mailing address
1120 15TH ST # OR6000, AUGUSTA, GA 30912-0004
(706) 721-3813

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
100353
GA
208600000X
Surgery Physician
52662
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
526620
SC
01
SCP6317628
MEDICARE PIN
SC
Enumeration date
06/28/2018
Last updated
07/16/2024
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