Provider Demographics
NPI:1588663058
Name:SAVANNAH PRIMARY CARE, LLC
Entity Type:Organization
Organization Name:SAVANNAH PRIMARY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CHARMATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-527-5250
Mailing Address - Street 1:1326 EISENHOWER DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3928
Mailing Address - Country:US
Mailing Address - Phone:912-527-5250
Mailing Address - Fax:912-527-5260
Practice Address - Street 1:1326 EISENHOWER DR
Practice Address - Street 2:SUITE D
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3928
Practice Address - Country:US
Practice Address - Phone:912-527-5250
Practice Address - Fax:912-527-5260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA207Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGPA844Medicaid
GA=========OtherTRICARE
GADA3328Medicare ID - Type UnspecifiedRAILROAD MEDICARE
GA=========OtherTRICARE