Provider Demographics
NPI:1205509858
Name:SAVANNAH ENDOCRINOLOGY LLC
Entity type:Organization
Organization Name:SAVANNAH ENDOCRINOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ISMARY
Authorized Official - Middle Name:OJEDA
Authorized Official - Last Name:DE CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-344-5037
Mailing Address - Street 1:107 SOUTHERN BLVD # 103
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-7437
Mailing Address - Country:US
Mailing Address - Phone:912-232-5900
Mailing Address - Fax:912-244-6744
Practice Address - Street 1:107 SOUTHERN BLVD # 103
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-7437
Practice Address - Country:US
Practice Address - Phone:912-232-5900
Practice Address - Fax:912-244-6744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty