Individual
OLGA FUNDYLER TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
203 INDIGO DR, BRUNSWICK, GA 31525-6865
(912) 261-2669
Mailing address
203 INDIGO DR., BRUNSWICK, GA 31525
(912) 261-2669
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
234186
MA
Other
Enumeration date
10/24/2007
Last updated
02/24/2017
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