Organization
COASTAL MEDICAL SPECIALISTS
Active
Other names
COASTAL MEDICAL SPECIALISTS IN LUNG & CRITICAL CARE, PC
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY LASHAWN DAVIS (OFFICE MANAGER)
(912) 354-7679
Entity
Organization
Contact information
Practice address
455 S MAIN ST, SUITE 105, HINESVILLE, GA 31313-4353
(912) 369-5864
Mailing address
3710 WATERS AVE, SAVANNAH, GA 31404-6209
(912) 354-7679
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
049393
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00900798C
—
GA
05
—
00900798D
—
GA
05
—
00900798E
—
GA
05
—
00900798F
—
GA
05
—
00900798G
—
GA
05
—
049393
—
SC
Enumeration date
02/15/2008
Last updated
02/15/2008
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