MEDICARE: DR. MARIA KRICHEVER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	049048	GA

General Provider Information

NPI Number	:	1558394627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA KRICHEVER M.D.

Provider Business Mailing Address
First Line	:	219 WILEY BOTTOM RD
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31411-1536
Country	:	US
Telephone Number	:	912-598-2126
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 MINIS AVE
Second Line	:	SUITE C-10
City	:	GARDEN CITY
State	:	GA
Zip	:	31408-2128
Country	:	US
Telephone Number	:	912-966-5445
Fax Number	:	912-966-5955

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	11/17/2009

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