Organization
SURGICAL ASSOCIATES OF EASTERN SHORE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMIE G GAVRAS MD (PHYSICIAN)
(251) 990-9191
Entity
Organization
Contact information
Practice address
767 MIDDLE ST, FAIRHOPE, AL 36532
(251) 990-9191
(251) 990-9189
Mailing address
767 MIDDLE ST, FAIRHOPE, AL 36532
(251) 990-9191
(251) 990-9189
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529702280
—
AL
Enumeration date
10/03/2006
Last updated
05/18/2016
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