Provider Demographics
NPI:1619100302
Name:MACHADO, MARIA CAROLINA CUNHA PINHEIRO
Entity Type:Individual
Prefix:
First Name:MARIA CAROLINA
Middle Name:CUNHA PINHEIRO
Last Name:MACHADO
Suffix:
Gender:F
Credentials:
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 1967
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-1967
Mailing Address - Country:US
Mailing Address - Phone:706-922-8251
Mailing Address - Fax:706-922-6695
Practice Address - Street 1:2467 GOLDEN CAMP RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-5515
Practice Address - Country:US
Practice Address - Phone:706-790-4440
Practice Address - Fax:706-790-4393
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD34431207RE0101X
GA74632207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSC62427979Medicare PIN