Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | LL34821 | SC |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 74912 | GA |
NPI | 1093078107 |
---|---|
Provider Name | Ann Simonin |
First Address | Savannah, GA 31404-6278 |
Second Address | Savannah, GA 31404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2012 |
Last Update Date | 15/07/2018 |