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Individual

DR. KERRY CHESTER DIVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1303 DANTIGNAC ST, SUITE #1200, AUGUSTA, GA 30901-2775
(706) 774-7760
(706) 774-7766
Mailing address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
(706) 729-5748

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
23041
GA

Other

Enumeration date
05/18/2006
Last updated
12/09/2015
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