Organization
DAVID KAVTARADZE MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KAVTARADZE MD (OWNER)
(229) 271-4608
Entity
Organization
Contact information
Practice address
902 N 7TH ST # 100, CORDELE, GA 31015-3234
(229) 276-2286
Mailing address
1008 N 7TH ST, CORDELE, GA 31015-3761
(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
—
000976214D
—
GA
Enumeration date
08/17/2010
Last updated
03/19/2021
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