Individual
STEVEN TIERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
DWIGHT DAVID EISENHOWER ARMY MEDICAL CENTER, FORT GORDON, GA 30905
(904) 805-1300
(904) 805-1302
Mailing address
4201 ASCOT CT, AUGUSTA, GA 30809
(706) 855-0769
(706) 855-5916
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
31341
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000458466B
—
GA
01
—
543066
BLUE CROSS
GA
01
—
G31341
SOUTH CAROLINA MEDICAID
SC
Enumeration date
06/23/2006
Last updated
12/01/2020
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