East Georgia Internal Medicine ,llc

NPI #1194835280 in Augusta, Georgia

Provider Information

NPI Number: 1194835280
Entity Type: Organization
Organization Name: East Georgia Internal Medicine ,llc
Primary Specialty: Internal Medicine
Enumeration Date: Aug 30, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 811 13TH ST
Address 2: SUITE 11
City: Augusta
State: Georgia
ZIP Code: 30901-2700
Phone: (706) 736-4154

Authorized Official

Name: OLADAPO O FAWIBE, M.D.
Title: DIRECTOR
Phone: (706) 736-4154

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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