Registry details
Type
Individual
Primary specialty
Internal Medicine, Medical Oncology
Enumerated
Jun 28, 2008
License(s)
D0063526 (MD), 64635 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3131 S MAIN ST COLQUITT REGIONAL MEDICAL CENTER | Moultrie, GA 31768-6925 | 229-985-3420 |
| MAILING | 214 CONGRESSIONAL LN APT 103 | Rockville, MD 20852-1521 | 786-564-1872 |
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