Organization
MPPG, INC.
Active
Other names
Memorial Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SEBRENA C. HOLMES GIBSON (PROVIDER ENROLLMENT COORDINATOR)
(912) 350-9335
Entity
Organization
Contact information
Practice address
6602 WATERS AVE, BLDG A, SAVANNAH, GA 31406-2758
(912) 350-6000
(912) 350-6001
Mailing address
PO BOX 102032, ATLANTA, GA 30368-2032
(912) 350-6000
(912) 350-6001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/29/2006
Last updated
06/20/2016
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