Organization
MPPG, INC.
Active
Other names
Memorial Health Savannah Mall
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR)
(912) 350-9335
Entity
Organization
Contact information
Practice address
14089 ABERCORN STREET, SAVANNAH, GA 31419
(912) 350-2138
(912) 350-2145
Mailing address
PO BOX 102032, ATLANTA, GA 30368-2032
(912) 350-2138
(912) 350-2145
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
12/08/2006
Last updated
06/01/2011
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