Organization
MATTHEW S PUGLIESE, M. D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA NELMS (PRACTICE MANAGER)
(706) 434-0130
Entity
Organization
Contact information
Practice address
820 SAINT SEBASTIAN WAY, SUITE 7C, AUGUSTA, GA 30901-2643
(706) 434-0130
(706) 434-0131
Mailing address
PO BOX 3346, AUGUSTA, GA 30914-3346
(706) 434-0130
(706) 434-0131
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
062417
GA
2086X0206X
Surgical Oncology Physician
Primary
062417
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143386616A
—
GA
Enumeration date
10/19/2009
Last updated
10/19/2009
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