Provider Demographics
NPI:1558394627
Name:KRICHEVER, MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:KRICHEVER
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 1:219 WILEY BOTTOM RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31411-1536
Mailing Address - Country:US
Mailing Address - Phone:912-598-2126
Mailing Address - Fax:
Practice Address - Street 1:109 MINIS AVE
Practice Address - Street 2:SUITE C-10
Practice Address - City:GARDEN CITY
Practice Address - State:GA
Practice Address - Zip Code:31408-2128
Practice Address - Country:US
Practice Address - Phone:912-966-5445
Practice Address - Fax:912-966-5955
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049048207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I083991Medicare UPIN
GA511G700201Medicare PIN