Individual
WILFREDO VERGARA DOLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6602 WATERS AVE BLDG A, SAVANNAH, GA 31406-2778
(912) 350-6000
(912) 350-6001
Mailing address
6602 WATERS AVE BLDG A, SAVANNAH, GA 31406-2778
(912) 350-6000
(912) 350-6001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
043922
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000788268E
—
GA
05
—
000788268G
—
GA
01
—
10064383
AMERIGROUP
GA
01
—
349752
WELLCARE
GA
01
—
52598660-005
BCBS
GA
05
—
G43922
—
SC
01
—
P00328076
RR MEDICARE
GA
Enumeration date
11/10/2005
Last updated
02/10/2022
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