Individual
MRS. MARIAN T EBRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2047 CENTRAL AVE, AUGUSTA, GA 30904-4178
(706) 738-7557
(706) 738-7526
Mailing address
2047 CENTRAL AVE, AUGUSTA, GA 30904-4178
(706) 738-7557
(706) 738-7526
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
041783
GA
207R00000X
Internal Medicine Physician
Primary
041783
GA
208D00000X
General Practice Physician
041783
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000709684B
—
GA
01
—
52678333 003
BCBSGA
GA
Enumeration date
05/23/2006
Last updated
01/03/2014
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