Individual
ALISON E NIEBANCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5002 WATERS AVE, SAVANNAH, GA 31404-6226
(912) 350-8180
(912) 350-5697
Mailing address
5002 WATERS AVE, SAVANNAH, GA 31404-6226
(912) 350-8180
(912) 350-5697
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
062581
GA
208000000X
Pediatrics Physician
M8873
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01366392
AMERIGROUP
—
05
—
217496162A
—
GA
05
—
G62581
—
SC
Enumeration date
07/03/2008
Last updated
08/07/2018
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