| Upward Health Of Georgia Llc | |
|
512 Peterson Ave S # 2006 Douglas GA 31533-5254 | |
| (888) 985-5455 | |
| Not Available |
| Full Name | Upward Health Of Georgia Llc |
|---|---|
| Speciality | General Practice |
| Location | 512 Peterson Ave S # 2006, Douglas, Georgia |
| Authorized Official Name and Position | Dennis Mihale (OWNER) |
| Authorized Official Contact | 8889855455 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upward Health Of Georgia Llc 80 Arkay Dr Ste 230 Hauppauge NY 11788-3705 Ph: (888) 985-5455 | Upward Health Of Georgia Llc 512 Peterson Ave S # 2006 Douglas GA 31533-5254 Ph: (888) 985-5455 |
| NPI Number | 1598357600 |
|---|---|
| Provider Enumeration Date | 02/09/2021 |
| Last Update Date | 11/08/2021 |
| Medicare PECOS PAC ID | 2264835925 |
|---|---|
| Medicare Enrollment ID | O20210720000329 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598357600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Dennis P H Mihale |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508025859 PECOS PAC ID: 0547585481 Enrollment ID: I20210720000487 |
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