Individual
SHANDA DEJOI NEWSOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1390 US HIGHWAY 19 S, LEESBURG, GA 31763-4831
(229) 312-7490
Mailing address
1390 US HIGHWAY 19 S, LEESBURG, GA 31763-4831
(229) 312-7490
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
73879
GA
Other
Enumeration date
04/17/2011
Last updated
01/18/2022
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