| Milca Altineus Ejimone, MD | |
|
1 Meadows Pkwy, Vidalia, GA 30474-8759 | |
| (912) 535-5555 | |
| Not Available |
| Full Name | Milca Altineus Ejimone |
|---|---|
| Gender | Female |
| Speciality | Anesthesiology |
| Location | 1 Meadows Pkwy, Vidalia, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952938482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 100065 (Georgia) | Primary |
| Entity Name | Se Georgia Anesthesia, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518542919 PECOS PAC ID: 8426466137 Enrollment ID: O20210419001856 |
| Mailing Address | Practice Location Address |
|---|---|
| Milca Altineus Ejimone, MD 1 Meadows Pkwy, Vidalia, GA 30474-8759 Ph: () - | Milca Altineus Ejimone, MD 1 Meadows Pkwy, Vidalia, GA 30474-8759 Ph: (912) 535-5555 |
Frank Gibase, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1 Meadows Pkwy, Vidalia, GA 30474 Phone: 912-538-5359 Fax: 912-538-5228 | |
Dr. Julie Ann Fitzgerald, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1 Meadows Pkwy, Vidalia, GA 30474 Phone: 912-535-5053 | |
Laila Mozdab, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1 Meadows Pkwy, Vidalia, GA 30474 Phone: 912-538-5359 Fax: 912-538-5228 | |
George A Ferrara, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1703 Meadows Ln, Vidalia, GA 30474 Phone: 912-538-5359 Fax: 912-538-5228 | |
Anthony D Mancuso, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1 Meadows Pkwy, Vidalia, GA 30474 Phone: 912-538-5359 Fax: 912-538-5228 |