Individual
DR. QUINTIN M PULIDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, FACS
Contact information
Practice address
2418 N OAK ST, SUITE F, VALDOSTA, GA 31602-2534
(229) 247-7220
(229) 247-0161
Mailing address
2418 N OAK ST, SUITE F, VALDOSTA, GA 31602-2534
(229) 247-7220
(229) 247-0161
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
019090
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000138487A
—
GA
01
—
023052
BLUE CROSS BLUE SHIELD GA
GA
01
—
037774100
FLORIDA MEDICAID
GA
01
—
46899
FIRST COAST MEDICARE
GA
01
—
P00076370
MEDICARE RAILROAD
GA
Enumeration date
05/24/2006
Last updated
08/16/2012
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