Organization
MOULTRIE UROLOGICAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAHA KASSIS BADDOUR RMM, MBA (PRACTICE MANAGER)
(229) 985-3066
Entity
Organization
Contact information
Practice address
2 HOSPITAL PARK, MOULTRIE, GA 31768-6700
(229) 985-3066
(229) 890-2092
Mailing address
2 HOSPITAL PARK, MOULTRIE, GA 31768-6700
(229) 985-3066
(229) 890-2092
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
031557
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00400518A
—
GA
Enumeration date
06/08/2007
Last updated
03/24/2010
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