Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 01060950A | IN |
Y | 207Q00000X | Family Doctor | 075674 | GA |
N | 208D00000X | General Practice Physician | 0101271553 | VA |
N | 208D00000X | General Practice Physician | 75674 | GA |
NPI | 1043227077 |
---|---|
Provider Name | Dr. Marvin Hubert Sineath JR. |
First Address | Savannah, GA 31404-5701 |
Second Address | Savannah, GA 31404-5701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PENDING | (05) | GA |