Frontline Internal Medicine LLC
Internal Medicine in Statesboro, GA. Organization (NPI-2).
NPI number1710328331
StatusActive
Last updated in NPPESOct 4, 2022
Details
- NPI
- 1710328331
- Entity type
- Organization (NPI-2)
- Legal business name
- Frontline Internal Medicine LLC
- Organization subpart
- No
- Enumeration date
- Jul 11, 2013
- Certification date
- Oct 4, 2022
- Last updated
- Oct 4, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 69221 | GA | Yes |
Practice location
6 Lester RdStatesboro, GA 30458-4786
Phone 912-681-8999 · Fax 912-681-8989
Mailing address
Po Box 1489Statesboro, GA 30459-1489
Phone 912-681-8999 · Fax 912-681-8989
Authorized official
Ogechi H Mbakwe
Solo Owner
9126818999
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