Agudelo, William Enrique

Agudelo, William Enrique is an individual health care provider with primary practice located at 380 Hospital Drive Suite 410, Macon GA 31217-8014. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Agudelo, William Enrique can be contacted via phone (478) 746-5644.

Contact Information

Primary practice address
380 Hospital Drive Suite 410 Macon GA 31217-8014
Phone: (478) 746-5644
Fax: (478) 745-4849
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APN2487 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN092922 Georgia

Profile Details

NPI number 1174512602
LBN Legal business name Agudelo, William Enrique
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Aug 27th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174512602 NPPES
South Carolina MEDICAID AN1387

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