Kavtaradze, David

Kavtaradze, David is an sole proprietor health care provider with primary practice located at 902 N 7Th St , Cordele GA 31015-3234. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Kavtaradze, David can be contacted via phone (229) 276-3100.

Contact Information

Primary practice address
902 N 7Th St Cordele GA 31015-3234
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 051148 Georgia
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 051148 Georgia

Profile Details

NPI number 1376516484
LBN Legal business name Kavtaradze, David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 9th, 2006
Last updated Feb 26th, 2021 - about 3 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 1376516484 NPPES
Georgia MEDICAID 000976214A

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