Individual
DR. RICHARD MAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
230 E DERENNE AVE, SAVANNAH, GA 31405-6736
(912) 790-4000
(912) 790-4407
Mailing address
5002 WATERS AVE, SAVANNAH, GA 31404-6226
(912) 350-7914
(912) 350-7973
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
028045
GA
2088P0231X
Pediatric Urology Physician
Primary
028045
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000324365F
—
GA
Enumeration date
04/20/2006
Last updated
01/04/2022
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