Organization
RICHARD J. NIJEM, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD J NIJEM M.D. (PRESIDENT)
(229) 244-9800
Entity
Organization
Contact information
Practice address
1700 N PATTERSON ST, VALDOSTA, GA 31602-2941
(229) 244-9800
(229) 244-5998
Mailing address
PO BOX 1086, VALDOSTA, GA 31603-1086
(229) 244-9800
(229) 244-5998
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
015405
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00133262A
—
GA
01
—
406063797
RAILROAD MEDICARE
GA
Enumeration date
08/19/2010
Last updated
09/28/2011
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