Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 008150 | GA |
N | 111NI0900X | Internist | 008150 | GA |
Y | 207RR0500X | Rheumatology | 80917 | GA |
NPI | 1083097349 |
---|---|
Provider Name | Renee Peterkin-Mccalman |
First Address | Augusta, GA 30901-2771 |
Second Address | Augusta, GA 30901-2771 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2015 |
Last Update Date | 12/11/2020 |