Organization
RAINBOW PEDIATRICS ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARSHA DANELL GLOVER M.D. (OWNER)
(229) 403-2046
Entity
Organization
Contact information
Practice address
16 HOSPITAL PARK, MOULTRIE, GA 31768-6700
(229) 228-0617
Mailing address
16 HOSPITAL PARK, MOULTRIE, GA 31768-6700
(229) 228-0617
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
034750
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003155912A
—
GA
Enumeration date
05/20/2015
Last updated
05/20/2015
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