Provider Demographics
NPI:1770874778
Name:EDUARD DOCU MD, LLC
Entity type:Organization
Organization Name:EDUARD DOCU MD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDUARD
Authorized Official - Middle Name:
Authorized Official - Last Name:DOCU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-354-3363
Mailing Address - Street 1:340 EISENHOWER DR STE 910
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-1609
Mailing Address - Country:US
Mailing Address - Phone:912-354-3363
Mailing Address - Fax:912-354-3332
Practice Address - Street 1:340 EISENHOWER DR STE 910
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-1609
Practice Address - Country:US
Practice Address - Phone:912-354-3363
Practice Address - Fax:912-354-3332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056426207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty