East Georgia Pediatrics

LBN: East Georgia Pediatrics
East Georgia Pediatrics is an health care organization with primary practice located at 715 Northside Dr E Suite 5 Pmb 398, Statesboro GA 30458-4712. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. East Georgia Pediatrics can be contacted via phone (912) 489-3325, or through Deal, Michael via phone (912) 489-3325.

Contact Information

Primary practice address
715 Northside Dr E Suite 5 Pmb 398 Statesboro GA 30458-4712
Phone: (912) 489-3325
Fax: (912) 764-4977
Website:
Map and Directions
Authorized official contact:
Name: Deal, Michael Doctor of Medicine (MD)
Phone: (912) 489-3325

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1295999795
LBN Legal business name East Georgia Pediatrics
DBA Doing business as
Authorized official Deal, Michael Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 14th, 2008
Last updated Jul 14th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295999795 NPPES
Georgia Other 10051619 AMERIGROUP
Georgia MEDICAID 000372391G AMERIGROUP
Georgia Other 354428 AMERIGROUP

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