Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 054411 | GA |
N | 208600000X | Surgeon | 054411 | GA |
Y | 2086S0102X | Surgical Critical Care | 054411 | GA |
NPI | 1346393279 |
---|---|
Provider Name | Heather G. Macnew |
First Address | Savannah, GA 31404-6278 |
Second Address | Savannah, GA 31404-6278 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 08/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01280084 | AMERIGROUP (01) | |
416981797A | (05) | GA |
514632 | WELLCARE (01) | GA |
G54411 | (05) | SC |
P00733495 | RR MEDICARE (01) | GA |