Individual
DR. WINONA R REBAGAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1514 ANTHONY RD, SUITE D, AUGUSTA, GA 30904-4817
(706) 733-3406
(706) 738-8757
Mailing address
1514 ANTHONY RD, SUITE D, AUGUSTA, GA 30904-4817
(706) 733-3406
(706) 738-8757
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00810675A
—
GA
01
—
G46219
SCMEDICAID
SC
Enumeration date
07/06/2006
Last updated
07/21/2022
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