Provider Demographics
NPI:1891777355
Name:DOCU, EDUARD (MD)
Entity Type:Individual
Prefix:
First Name:EDUARD
Middle Name:
Last Name:DOCU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 EISENHOWER DR STE 910
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-1609
Mailing Address - Country:US
Mailing Address - Phone:912-354-3363
Mailing Address - Fax:912-354-3332
Practice Address - Street 1:340 EISENHOWER DR STE 910
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-1609
Practice Address - Country:US
Practice Address - Phone:912-354-3363
Practice Address - Fax:912-354-3332
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056424207Q00000X
GA056426207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA046942388AMedicaid
GA08CBBLXOtherMEDICARE
GA046942388AMedicaid