Individual
ROGELIO DELA CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 CENTER ST, COLUMBUS, GA 31901-1527
(706) 571-1311
Mailing address
2490 RIVERSIDE DR, STE B, MACON, GA 31204-1787
(478) 633-7140
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
054482
GA
208000000X
Pediatrics Physician
054482
GA
2080P0203X
Pediatric Critical Care Medicine Physician
054482
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
754171554B
—
GA
Enumeration date
02/28/2006
Last updated
08/12/2022
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