Individual
GEORGE E MAULE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3651 WHEELER RD, AUGUSTA, GA 30909-6521
(706) 855-9860
(706) 860-7124
Mailing address
PO BOX 204097, AUGUSTA, GA 30907
(706) 855-9860
(706) 860-7124
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN092875
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000561558I
—
GA
01
—
10063588
AMERIGROUP
GA
01
—
430077074
RAILROAD MEDICARE
GA
05
—
GAN130
—
SC
Enumeration date
05/01/2006
Last updated
07/08/2011
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