Provider Demographics
NPI:1801087432
Name:SYNERGY MEDICAL CENTER OF SAVANNAH
Entity type:Organization
Organization Name:SYNERGY MEDICAL CENTER OF SAVANNAH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:L
Authorized Official - Last Name:DINGELDEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-691-1991
Mailing Address - Street 1:349 MALL BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-4742
Mailing Address - Country:US
Mailing Address - Phone:912-691-1991
Mailing Address - Fax:912-691-1990
Practice Address - Street 1:349 MALL BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-4742
Practice Address - Country:US
Practice Address - Phone:912-691-1991
Practice Address - Fax:912-691-1990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007674111N00000X
GA019599174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty