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Individual

IVETTE D RICO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5102 PAULSEN ST, BLDG 3, SAVANNAH, GA 31405-4601
(912) 644-4900
(912) 691-0923
Mailing address
5102 PAULSEN ST, BLDG 3, SAVANNAH, GA 31405-4601
(912) 644-4900
(912) 691-0923

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
037450
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000576391A
GA
05
000576391B
GA
Enumeration date
12/09/2005
Last updated
10/31/2011
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