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Individual

DEV PADIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
922 E JEFFERSON ST, SUITE B, AMERICUS, GA 31709-4780
(347) 930-1389
Mailing address
106 MACON ST, OGLETHORPE, GA 31068-4445

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06231984
PHOEBE SUMTER MEDICAL CENTER
Enumeration date
04/04/2012
Last updated
04/04/2012
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