NPI 1104113307

Provident Health Surgical Associates, INC.

Organisation Surgery Physician Savannah, GA

Practice location

Address: 4700 Waters Ave Suite 405, Savannah, GA 31404-6220
Phone: (912) 350-2700
Fax: (912) 350-2715

Authorised official

Name: Robin J. Maddox
Title: Provider Enrollment Coordinator
Phone: (912) 350-9335

Registered specialties (2)

Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208600000X

Other Surgery providers in Georgia →

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363L00000X

Other Nurse Practitioner providers in Georgia →

Registry record

NPI: 1104113307
Entity type: Organization
NPI issued: 8 Jul 2011
Record last updated: 8 Jul 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.