MARSHES MEDICAL DIAGNOSTIC CLINIC PC NPI 1013922699

NPI Information

NPI: 1013922699
Provider Name: MARSHES MEDICAL DIAGNOSTIC CLINIC, PC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

CLIA Number: 11D0265224

Address:
2705 WILDWOOD DR
BRUNSWICK, GA
ZIP 31520
Phone: (912) 264-6133
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MARSHES MEDICAL DIAGNOSTIC CLINIC, PC is a nephrology internal medicine in Brunswick, GA. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. MARSHES MEDICAL DIAGNOSTIC CLINIC, PC NPI is 1013922699. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2705 WILDWOOD DR
BRUNSWICK, GA
ZIP 31520-346
Phone: (912) 264-6133
Fax: (912) 267-1415

The provider's authorized official is Andrea Page Callahan .
The authorized official title is Sec/treas and has the following contact phone number (912) 264-6133.

The CLIA number assigned to this NPI record is 11D0265224 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/30/2006 and was last updated on 6/1/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine				No
2	207RN0300X	Internal Medicine	Nephrology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GRP 1465	OTHER	GEORGIA	CAHABA MEDICARE
2	CL1232	OTHER	GEORGIA	RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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