| Tom John Albunian Mayuga, DO | |
|
507 Park St, Palmetto, GA 30268-1007 | |
| (770) 463-4644 | |
| Not Available |
| Full Name | Tom John Albunian Mayuga |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 507 Park St, Palmetto, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902433246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 93028 (Georgia) | Primary |
| Entity Name | Mayuga Family Medicine Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972203735 PECOS PAC ID: 5496111262 Enrollment ID: O20230522000161 |
| Entity Name | Palmetto Health Council Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184884678 PECOS PAC ID: 3476586629 Enrollment ID: O20250404002525 |
| Mailing Address | Practice Location Address |
|---|---|
| Tom John Albunian Mayuga, DO 507 Park St, Palmetto, GA 30268-1007 Ph: (770) 463-4644 | Tom John Albunian Mayuga, DO 507 Park St, Palmetto, GA 30268-1007 Ph: (770) 463-4644 |
Joanne E. Williams, MD, MPH Family Medicine Medicare: Medicare Enrolled Practice Location: 643 Main St, Palmetto, GA 30268 Phone: 404-929-8824 | |
Gabriela Pena, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 643 Main St, Palmetto, GA 30268 Phone: 404-929-8824 | |
Dr. Milanieva Latorre, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 643 Main St, Palmetto, GA 30268 Phone: 404-929-8824 Fax: 404-929-9769 | |
Matthew Charles Revilla, PA-C Family Medicine Medicare: Medicare Enrolled Practice Location: 507 Park St, Palmetto, GA 30268 Phone: 770-463-4644 |