Individual
GRACE C. BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
103 WEST GENERAL SCREVEN WAY, SUITE E, HINESVILLE, GA 31313
(912) 877-7338
(912) 876-3558
Mailing address
103 WEST GENERAL SCREVEN WAY, SUITE E, HINESVILLE, GA 31313
(912) 877-7338
(912) 876-3558
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16775
GA
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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