Individual
JOHNNY SY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4700 WATERS AVE, DEPARTMENT OF EMERGENCY MEDICINE, SAVANNAH, GA 31404-6220
(912) 350-8113
Mailing address
4700 WATERS AVE, DEPARTMENT OF EMERGENCY MEDICINE, SAVANNAH, GA 31404-6220
(912) 350-8113
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
58826
GA
207P00000X
Emergency Medicine Physician
UO1082
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01062450
AMERIGROUP
GA
01
—
393120
WELLCARE
GA
01
—
633234877C
PEACHSTATE
GA
05
—
633234877C
—
GA
05
—
G58826
—
SC
Enumeration date
01/16/2007
Last updated
06/03/2008
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