| Southeast Internal Medicine Pc | |
|
406 Riverside Dr Waycross GA 31501-5315 | |
| (912) 287-1555 | |
| Not Available |
| Full Name | Southeast Internal Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 406 Riverside Dr, Waycross, Georgia |
| Authorized Official Name and Position | Pauline M Bellecci (PHYSICIAN) |
| Authorized Official Contact | 9122871555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Internal Medicine Pc Po Box 777 Waycross GA 31502-0777 Ph: (912) 287-1555 | Southeast Internal Medicine Pc 406 Riverside Dr Waycross GA 31501-5315 Ph: (912) 287-1555 |
| NPI Number | 1104847607 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 06/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104847607 | NPI | - | NPPES |
| GRP642 | Other | GA | MEDICARE PTAN |
| CC4999 | Other | GA | PALMETTO GBA MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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