Provider Demographics
NPI:1336115187
Name:KALDAS, EMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:EMAN
Middle Name:
Last Name:KALDAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1705
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30903-1705
Mailing Address - Country:US
Mailing Address - Phone:706-774-7263
Mailing Address - Fax:706-774-7230
Practice Address - Street 1:3486 PEACH ORCHARD RD STE 200
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-5196
Practice Address - Country:US
Practice Address - Phone:706-828-8049
Practice Address - Fax:706-828-8048
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049579207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA009292133AMedicaid
GA000929223BMedicaid
GA202I113822Medicare PIN
GAH53757Medicare UPIN
GA000929223BMedicaid