Provider Demographics
NPI:1700879418
Name:MCCULLARS, GEORGE M (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:M
Last Name:MCCULLARS
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:11035 CELESTE RD
Mailing Address - Street 2:
Mailing Address - City:SARALAND
Mailing Address - State:AL
Mailing Address - Zip Code:36571-9707
Mailing Address - Country:US
Mailing Address - Phone:251-342-1808
Mailing Address - Fax:251-342-1838
Practice Address - Street 1:1 TIMBER WAY STE 202
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36527-5634
Practice Address - Country:US
Practice Address - Phone:251-342-1808
Practice Address - Fax:251-342-1838
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-27
Last Update Date:2021-05-19
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Provider Licenses
StateLicense IDTaxonomies
ALMD.10172207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC70223Medicare UPIN