Provider Demographics
NPI:1922407162
Name:UMG GASTROENTEROLOGY LLC
Entity Type:Organization
Organization Name:UMG GASTROENTEROLOGY LLC
Other - Org Name:UNIVERSITY GASTROENTEROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, VP
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELKOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-774-7263
Mailing Address - Street 1:PO BOX 1705
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30903-1705
Mailing Address - Country:US
Mailing Address - Phone:706-774-7263
Mailing Address - Fax:706-774-7230
Practice Address - Street 1:820 SAINT SEBASTIAN WAY STE 2F
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2636
Practice Address - Country:US
Practice Address - Phone:706-774-5790
Practice Address - Fax:706-774-5763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty