Provider Demographics
NPI:1700809688
Name:SAVANNAH HEART,P.C.
Entity Type:Organization
Organization Name:SAVANNAH HEART,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:AZUBIKE
Authorized Official - Last Name:NWOSU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-355-0490
Mailing Address - Street 1:322 COMMERCIAL DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3625
Mailing Address - Country:US
Mailing Address - Phone:912-355-0490
Mailing Address - Fax:912-355-0608
Practice Address - Street 1:322 COMMERCIAL DR STE 1
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3639
Practice Address - Country:US
Practice Address - Phone:912-355-0490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035489174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGPA648Medicaid
SCGPA648Medicaid
GACG3021Medicare ID - Type UnspecifiedRAILROAD GA MEDICARE