| Internal Medicine Of Savannah, Llc | |
|
6413 Waters Ave Suite 102 Savannah GA 31406-2711 | |
| (912) 349-6624 | |
| (912) 354-4694 |
| Full Name | Internal Medicine Of Savannah, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6413 Waters Ave, Savannah, Georgia |
| Authorized Official Name and Position | Robin J. Maddox (PROVIDER ENROLLMENT COORDINATOR) |
| Authorized Official Contact | 9123508977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Of Savannah, Llc 6413 Waters Ave Suite 102 Savannah GA 31406-2711 Ph: (912) 349-6624 | Internal Medicine Of Savannah, Llc 6413 Waters Ave Suite 102 Savannah GA 31406-2711 Ph: (912) 349-6624 |
| NPI Number | 1346514114 |
|---|---|
| Provider Enumeration Date | 02/26/2012 |
| Last Update Date | 09/02/2015 |
| Medicare PECOS PAC ID | 2466614425 |
|---|---|
| Medicare Enrollment ID | O20120509000061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346514114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Yulianty D Kusuma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265627145 PECOS PAC ID: 8426121450 Enrollment ID: I20080723000682 |
| Provider Name | Darcy Anne Racoff Glascock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851762801 PECOS PAC ID: 5092056770 Enrollment ID: I20190405001132 |
| Provider Name | Samantha Soto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861117129 PECOS PAC ID: 9234678681 Enrollment ID: I20240829000211 |
Memorial Physicians Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4731 Waters Ave, Savannah, GA 31404 Phone: 912-350-4905 Fax: 912-350-4955 | |
Coastal Community Health Services, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1107 E 66th St, Savannah, GA 31404 Phone: 912-350-8408 | |
Mppg, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4731 Waters Ave, Savannah, GA 31404 Phone: 912-350-4905 Fax: 912-350-4955 | |
Union Mission, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 Fahm St, Savannah, GA 31401 Phone: 912-495-8887 Fax: 912-495-8889 | |
Curtis V. Cooper Primary Health Care, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4451 Paulsen St, Savannah, GA 31405 Phone: 912-527-1005 Fax: 912-527-1126 | |
Dynamic Loop Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Bull St # 200, Savannah, GA 31401 Phone: 470-332-5035 Fax: 888-977-3104 | |
Steadfast Family Medicine, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4790 Waters Ave Ste 400, Savannah, GA 31404 Phone: 912-866-1220 |