Individual
DR. RAYMOND EUGENE TIDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 RIVERSTONE VIS, SUITE 205, BLUE RIDGE, GA 30513-6648
(706) 632-4400
(706) 632-4404
Mailing address
101 RIVERSTONE VIS, BLUE RIDGE, GA 30513-6648
(706) 632-4400
(706) 632-4404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
032826
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
428836
BC/BS
GA
Enumeration date
07/20/2005
Last updated
04/01/2008
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