Provider Demographics
NPI:1891787636
Name:WARE, CYNTHIA R (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:R
Last Name:WARE
Suffix:
Gender:F
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:PO BOX 15849
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-2549
Mailing Address - Country:US
Mailing Address - Phone:912-303-3552
Mailing Address - Fax:912-303-3506
Practice Address - Street 1:5354 REYNOLDS ST
Practice Address - Street 2:SUITE 424
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6007
Practice Address - Country:US
Practice Address - Phone:912-819-5999
Practice Address - Fax:912-819-5980
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2023-03-07
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2007-05-11
Provider Licenses
StateLicense IDTaxonomies
GA044861207R00000X
SC28727207R00000X
MO2009034013207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000781426EMedicaid
GABW5292925OtherDEA
GA000781426EMedicaid
GABW5292925OtherDEA