Organization
GEORGIA NEUROLOGY AND REHAB
Active
Other names
Coastal Neurological Institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL T SHENKMAN M.D (CEO)
(912) 265-1357
Entity
Organization
Contact information
Practice address
1111 GLYNCO PARKWAY, SUITE 400, BRUNSWICK, GA 31525
(912) 265-1357
(912) 265-0495
Mailing address
1111 GLYNCO PARKWAY, SUITE 400, BRUNSWICK, GA 31525
(912) 265-1357
(912) 265-0495
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036000
GA
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000516942H
—
GA
01
—
DC7432
RAILROAD MEDICARE PIN
GA
Enumeration date
09/15/2006
Last updated
11/03/2011
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