Individual
DR. ALICIA S ESTILLORE-CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
603 WHEAT AVE, BAINBRIDGE, BAINBRIDGE, GA 39819-4360
(229) 246-1209
(229) 243-7707
Mailing address
603 WHEAT AVE, BAINBRIDGE, BAINBRIDGE, GA 39819-4360
(229) 246-1209
(229) 243-7707
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
045780
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000803393A
—
GA
05
—
000803393B
—
GA
Enumeration date
05/24/2006
Last updated
04/13/2012
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