Provider Demographics
NPI:1902846223
Name:LANDA, MICHAEL STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:LANDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8 STEPHENSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5802
Mailing Address - Country:US
Mailing Address - Phone:912-355-1091
Mailing Address - Fax:912-352-7378
Practice Address - Street 1:8 STEPHENSON AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5802
Practice Address - Country:US
Practice Address - Phone:912-355-1091
Practice Address - Fax:912-352-7378
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA049422207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00297614OtherRAILROAD MEDICARE
GA000894484EMedicaid
F17890Medicare UPIN
GA18BDGNDMedicare ID - Type Unspecified