STATESBORO CARDIOLOGY PC NPI 1205840105

NPI Information

STATESBORO CARDIOLOGY, PC is a cardiovascular disease internal medicine in Statesboro, GA. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. STATESBORO CARDIOLOGY, PC NPI is 1205840105. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5 GRADY JOHNSON RD
STATESBORO, GA
ZIP 30458-026
Phone: (912) 489-6843
Fax: (912) 489-6346

The provider's authorized official is Stanley J Shin .
The authorized official title is Ceo and has the following contact phone number (912) 489-6246.

The CLIA number assigned to this NPI record is 11D0939813 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/28/2006 and was last updated on 11/9/2020.

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:

Other Identifiers

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