Individual
ANDREW STEFAN MRUGALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 SAINT JOSEPHS CANDLER DR STE 200, POOLER, GA 31322-9585
(912) 748-1999
(912) 748-3847
Mailing address
101 ST. JOSEPH'S CANDLER DRIVE, SUITE 200, POOLER, GA 31322
(912) 748-1999
(912) 748-3847
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2019-01744
NC
207Q00000X
Family Medicine Physician
Primary
86158
GA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
86158
GA
208M00000X
Hospitalist Physician
2019-01744
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003235519A
—
GA
01
—
11018773A
STATE LICENSE
IN
Enumeration date
06/03/2016
Last updated
11/06/2023
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