Mazo, Richard

Mazo, Richard is an individual health care provider with primary practice located at 230 E Derenne Ave , Savannah GA 31405-6736. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Urology, Allopathic & Osteopathic Physicians / Pediatric Urology. Allopathic & Osteopathic Physicians / Pediatric Urology is his primary health care specialty. Mazo, Richard can be contacted via phone (912) 790-4000.

Contact Information

Primary practice address
230 E Derenne Ave Savannah GA 31405-6736
Phone: (912) 790-4000
Fax: (912) 790-4407
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 028045 Georgia
Allopathic & Osteopathic Physicians / Pediatric Urology 2088P0231X 028045 Georgia

Profile Details

NPI number 1760447890
LBN Legal business name Mazo, Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Jan 4th, 2022 - about 2 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 1760447890 NPPES
Georgia MEDICAID 000324365F

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