Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 0101244675 | VA |
NPI | 1013197276 |
---|---|
Provider Name | Dr. Monica Lynn Colombo |
First Address | Fort Stewart, GA 31314-5674 |
Second Address | Fort Stewart, GA 31314-5674 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2007 |
Last Update Date | 14/11/2013 |