Pennington, Michele Lee

Pennington, Michele Lee is an individual health care provider with primary practice located at 817 Griffin Ave , Eastman GA 31023-6718. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Pennington, Michele Lee can be contacted via phone (478) 374-0020.

Contact Information

Primary practice address
817 Griffin Ave Eastman GA 31023-6718
Phone: (478) 374-0020
Fax: (478) 374-2937
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301070192 Michigan
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 063003 Georgia

Profile Details

NPI number 1093793622
LBN Legal business name Pennington, Michele Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2006
Last updated Sep 1st, 2010 - about 14 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 1093793622 NPPES
Michigan Other 0801975377 RAILROAD MEDICARE
Michigan Other 0806346602 RAILROAD MEDICARE
Michigan MEDICAID 166083196D RAILROAD MEDICARE
Michigan Other 202I082364 RAILROAD MEDICARE
Michigan MEDICAID 1093793622 RAILROAD MEDICARE
Michigan Other 0806346602 RAILROAD MEDICARE

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