Healthcare Provider Details

I. General information

NPI: 1699417147
Provider Name (Legal Business Name): ANDREW PACK GEORGE I MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 REYNOLDS ST STE 222
SAVANNAH GA
31405-6015
US

IV. Provider business mailing address

5353 REYNOLDS ST STE 222
SAVANNAH GA
31405-6015
US

V. Phone/Fax

Practice location:
  • Phone: 912-819-5999
  • Fax: 912-303-3506
Mailing address:
  • Phone: 912-819-5999
  • Fax: 912-303-3506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number114038
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: