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Individual

DR. MANUEL B CUESTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
105 E TOLLISON ST STE B, BAXLEY, GA 31513-0150
(912) 366-6600
(912) 367-7841
Mailing address
PO BOX 2070, BAXLEY, GA 31515-2070
(912) 367-0102
(912) 367-9966

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
018286
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000857018E
GA
Enumeration date
05/22/2006
Last updated
09/02/2020
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