Individual
CAROL ASFOURA MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 502-9753
Mailing address
3131 S MAIN ST, MOULTRIE, GA 31768-6925
(229) 502-9753
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
104428
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2023
Last updated
07/24/2025
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