Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CHIR010162 | GA |
NPI | 1285152470 |
---|---|
Provider Name | Dr. Marc Charles Case |
First Address | Saint Marys, GA 31558-3886 |
Second Address | Saint Marys, GA 31558-3886 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2017 |
Last Update Date | 16/10/2019 |