MEDICARE: SAVANNAH PAIN MANAGEMENT, INC.

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	302R00000X	Health Maintenance Organization	040438	GA
2	305S00000X	Point of Service	040438	GA
3	302F00000X	Exclusive Provider Organization	040438	GA
4	305R00000X	Preferred Provider Organization	040438	GA

General Provider Information

NPI Number	:	1932399722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAVANNAH PAIN MANAGEMENT, INC.

Provider Business Mailing Address
First Line	:	455 PHILIP BLVD STE 140
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30046-8768
Country	:	US
Telephone Number	:	912-629-2210
Fax Number	:	912-352-4616

Provider Business Practice Location Address
First Line	:	8 WHEELER ST
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405
Country	:	US
Telephone Number	:	912-629-2210
Fax Number	:	912-352-4616

Authorized Official
Title or Position	:	CEO
Name	:	MR. AMIT S PATEL
Credential	:	M.D.
Telephone Number	:	770-962-3642

Provider Enumeration Date	:	07/27/2007
Last Update Date	:	02/05/2026

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