Provider Demographics
NPI:1871823302
Name:SATILLA RHEUMATOLOGY AND INTERNAL MEDICINE, PC
Entity Type:Organization
Organization Name:SATILLA RHEUMATOLOGY AND INTERNAL MEDICINE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:GALEA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-548-0710
Mailing Address - Street 1:615-A PENDLETON STREET
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-4724
Mailing Address - Country:US
Mailing Address - Phone:912-548-0710
Mailing Address - Fax:912-548-0071
Practice Address - Street 1:615-A PENDLETON STREET
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-4724
Practice Address - Country:US
Practice Address - Phone:912-548-0710
Practice Address - Fax:912-548-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055229174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty