WINDER SURGICAL SPECIALIST NPI 1639345507

NPI Information

  • NPI: 1639345507
  • Provider Name: WINDER SURGICAL SPECIALIST
  • Classification: Surgery - 208600000X
  • Entity Type: Organization
  • Address: 314 N BROAD ST
    SUITE 350
    WINDER, GA
    ZIP 30680
  • Phone: (770) 307-1305

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NPI Details

WINDER SURGICAL SPECIALIST is a surgery in Winder, GA. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. WINDER SURGICAL SPECIALIST NPI is 1639345507. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

314 N BROAD ST
SUITE 350
WINDER, GA
ZIP 30680-191
Phone: (770) 307-1305
Fax: (770) 307-1522

The provider's authorized official is Cesar Medalla Delima .
The authorized official title is Provider and has the following contact phone number (770) 307-1305.

The enumeration date for this NPI number is 5/1/2008 and was last updated on 6/4/2008.

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
1208600000XSurgery028396GEORGIAYes

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
152238010OTHERGEORGIABLUE CROSS BLUE SHIELD
2511G700471MEDICARE OSCAR/CERTIFICATIONGEORGIA
3000324244DMEDICAIDGEORGIA
4D39721MEDICARE UPINGEORGIA

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: 11/21/2025

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