Healthcare Provider Details

I. General information

NPI: 1417391350
Provider Name (Legal Business Name): CHRISTOPHER SOSA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2013
Last Update Date: 09/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 REYNOLDS ST
SAVANNAH GA
31405
US

IV. Provider business mailing address

5353 REYNOLDS ST
SAVANNAH GA
31405
US

V. Phone/Fax

Practice location:
  • Phone: 912-819-6000
  • Fax:
Mailing address:
  • Phone: 912-819-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number076820
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: