Haven Medical Home PC
Internal Medicine in Evans, GA. Organization (NPI-2).
NPI number1114587763
StatusActive
Last updated in NPPESAug 5, 2020
Details
- NPI
- 1114587763
- Entity type
- Organization (NPI-2)
- Legal business name
- Haven Medical Home PC
- Organization subpart
- No
- Enumeration date
- Jun 17, 2019
- Certification date
- Aug 5, 2020
- Last updated
- Aug 5, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
Practice location
4480 Deer RunEvans, GA 30809-4442
Phone 706-833-8810 · Fax 800-504-1362
Mailing address
4480 Deer RunEvans, GA 30809-4442
Phone 706-833-8810 · Fax 800-504-1362
Authorized official
Jennifer Ward
Owner
7068338810
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Other Internal Medicine Physician providers in Evans, GA
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- Jimmy V. Lemke, M.D.NPI 1669527156
- Christopher S McElroy, M.D.NPI 1346343134
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All 22 Internal Medicine Physician providers in Evans · All 1,218 providers in Evans
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