Provider Demographics
NPI:1740225523
Name:SAVANNAH NEUROLOGY PC
Entity Type:Organization
Organization Name:SAVANNAH NEUROLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-353-3333
Mailing Address - Street 1:5356 REYNOLDS ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6016
Mailing Address - Country:US
Mailing Address - Phone:912-353-3333
Mailing Address - Fax:912-790-4840
Practice Address - Street 1:5356 REYNOLDS ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6016
Practice Address - Country:US
Practice Address - Phone:912-353-3333
Practice Address - Fax:912-790-4840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP5056Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER