Organization
COLQUITT REGIONAL EMERGENCY PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAMB PUROHIT (CFO)
(229) 502-9703
Entity
Organization
Contact information
Practice address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 336-4621
Mailing address
PO BOX 3697, 3131 S. MAIN ST, MOULTRIE, GA 31776-3697
(800) 579-7777
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
06/20/2014
Last updated
06/20/2014
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