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Individual

EVER SAMUEL BOBADILLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
915 RUSSELL ST, AUGUSTA, GA 30904-4115
(706) 738-4925
(706) 738-7224
Mailing address
3682 FOXFIRE PL, AUGUSTA, GA 30907-8951
(706) 855-8643

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
048979
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00881471A
GA
Enumeration date
07/18/2006
Last updated
07/08/2007
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