Provider Demographics
NPI:1083662241
Name:ASSORGI, SALVATORE C (DO)
Entity Type:Individual
Prefix:DR
First Name:SALVATORE
Middle Name:C
Last Name:ASSORGI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MALL BLVD STE 202E
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4834
Mailing Address - Country:US
Mailing Address - Phone:912-349-4945
Mailing Address - Fax:912-349-4105
Practice Address - Street 1:14089 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1966
Practice Address - Country:US
Practice Address - Phone:912-777-6161
Practice Address - Fax:912-436-6463
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA36087207Q00000X
SC731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG36087Medicaid
SCG36087Medicaid