Provider Demographics
NPI:1659565554
Name:G. SAURINA, MD PC
Entity Type:Organization
Organization Name:G. SAURINA, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAURINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MSC
Authorized Official - Phone:229-245-0666
Mailing Address - Street 1:2301 N ASHLEY ST
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2620
Mailing Address - Country:US
Mailing Address - Phone:229-245-0666
Mailing Address - Fax:229-245-1988
Practice Address - Street 1:2301 N ASHLEY STREET
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2620
Practice Address - Country:US
Practice Address - Phone:229-245-0666
Practice Address - Fax:229-245-1988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA048570207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4833Medicare PIN