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Individual

DAVID W RETTERBUSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
403 COWART AVE, VALDOSTA, GA 31602-2635
(229) 244-0034
(229) 244-1871
Mailing address
PO BOX 3638, VALDOSTA, GA 31604-3638
(229) 244-0034
(229) 244-1871

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20145
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000193278A
GA
Enumeration date
04/29/2008
Last updated
04/29/2008
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