Provider Demographics
NPI:1407863707
Name:CIBIK, GEORGE M (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:M
Last Name:CIBIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 POWERS FERRY RD NW STE 600-334
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2919
Mailing Address - Country:US
Mailing Address - Phone:770-862-0557
Mailing Address - Fax:770-951-5641
Practice Address - Street 1:6300 POWERS FERRY RD NW STE 600-334
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2919
Practice Address - Country:US
Practice Address - Phone:770-862-0557
Practice Address - Fax:770-951-5641
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021487207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00214519FMedicaid
GA10BBBMZMedicare ID - Type Unspecified
GA00214519FMedicaid