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Contact Information

SCREVEN COUNTY FAMILY MEDICINE
215 MIMS ROAD
SYLVANIA, GA30467
 Phone: 912-564-9285
 Fax: 912-564-2174
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for SCREVEN COUNTY FAMILY MEDICINE · (Female)

NPI # 1407010689
Status Active
Credentials
Entity Individual
Enumeration date 07/16/2008
Last updated 07/16/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 058087
  • GA Medicaid 251294760D
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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