Provider Demographics
NPI:1457481558
Name:ASANTE, GEORGINA (DPM)
Entity Type:Individual
Prefix:
First Name:GEORGINA
Middle Name:
Last Name:ASANTE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 10TH AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-3600
Mailing Address - Country:US
Mailing Address - Phone:706-576-6844
Mailing Address - Fax:706-576-4779
Practice Address - Street 1:1900 10TH AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3600
Practice Address - Country:US
Practice Address - Phone:706-576-6844
Practice Address - Fax:706-576-4779
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000628213ES0103X, 213E00000X, 213EP1101X, 213ER0200X, 213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA673506OtherBLUE CROSS BLUE SHIELD
GA000452856CMedicaid
GA000452856CMedicaid
4987960001Medicare NSC