Individual
DR. MARIA A MOOGERFELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1088A BERMUDA RUN, STATESBORO, GA 30458-0858
(912) 681-7111
Mailing address
1449 BRAMPTON AVE, STATESBORO, GA 30458-0854
(912) 681-7111
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
051893
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52841448
BCBS GEORGIA
GA
05
—
754283113A
—
GA
05
—
754283113B
—
GA
Enumeration date
01/08/2007
Last updated
10/19/2020
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