Individual
MISS ANNIE MCKAY DELISO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4750 WATERS AVE STE 202, SAVANNAH, GA 31404-6278
(912) 350-7412
Mailing address
301 PASSAGE WAY APT 3099, SAVANNAH, GA 31401-2998
(860) 951-2629
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
11351
GA
363A00000X
Physician Assistant
Primary
11351
GA
363A00000X
Physician Assistant
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—
Other
Enumeration date
01/09/2023
Last updated
02/13/2023
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