Individual
JAVIER JOSE POLANIA GUTIERREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2273
Mailing address
726 HICKMAN RD APT 7, AUGUSTA, GA 30904-4226
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
12889
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12889
—
GA
Enumeration date
06/04/2021
Last updated
06/04/2021
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