Southeast Internal Medicine Pc

LBN: Southeast Internal Medicine Pc
Southeast Internal Medicine Pc is an health care organization with primary practice located at 406 Riverside Dr , Waycross GA 31501-5315. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Southeast Internal Medicine Pc can be contacted via phone (912) 287-1555, or through Bellecci, Pauline M via phone (912) 287-1555.

Contact Information

Primary practice address
406 Riverside Dr Waycross GA 31501-5315
Phone: (912) 287-1555
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Bellecci, Pauline M Doctor of Medicine (MD)
Phone: (912) 287-1555

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1104847607
LBN Legal business name Southeast Internal Medicine Pc
DBA Doing business as
Authorized official Bellecci, Pauline M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 21st, 2006
Last updated Jun 5th, 2014 - about 11 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 1104847607 NPPES
Georgia Other GRP642 MEDICARE PTAN
Georgia Other CC4999 MEDICARE PTAN

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