SOUTHCOAST MEDICAL GROUP LLC NPI 1861745119

NPI Information

NPI: 1861745119
Provider Name: SOUTHCOAST MEDICAL GROUP, LLC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
1326 EISENHOWER DR
SAVANNAH, GA
ZIP 31406
Phone: (912) 691-4100
Get Directions

SOUTHCOAST MEDICAL GROUP, LLC is a nephrology internal medicine in Savannah, 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. SOUTHCOAST MEDICAL GROUP, LLC NPI is 1861745119. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1326 EISENHOWER DR
SAVANNAH, GA
ZIP 31406-928
Phone: (912) 691-4100
Fax: (912) 691-4209

The provider's authorized official is John Marrero .
The authorized official title is Administrator and has the following contact phone number (912) 303-3552.

The enumeration date for this NPI number is 10/24/2012 and was last updated on 10/24/2012.

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	207Q00000X	Family Medicine		020999	GEORGIA	No
2	207R00000X	Internal Medicine		038715	GEORGIA	No
3	207W00000X	Ophthalmology		026247	GEORGIA	No
4	2084N0400X	Psychiatry & Neurology	Neurology	064752	GEORGIA	No
5	2085R0202X	Radiology	Diagnostic Radiology	039937	GEORGIA	No
6	363A00000X	Physician Assistant		5306	GEORGIA	No
7	363L00000X	Nurse Practitioner		RN077768	GEORGIA	No
8	207RN0300X	Internal Medicine	Nephrology	047425	GEORGIA	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	GRP2728	MEDICARE PIN	GEORGIA

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: 4/28/2024

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