Healthcare Provider Details

I. General information

NPI: 1679006779
Provider Name (Legal Business Name): MERRITT KALUZNE DAMMEYER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MERRITT ELIZABETH KALUZNE

II. Dates (important events)

Enumeration Date: 04/05/2017
Last Update Date: 10/16/2022
Certification Date: 10/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WHEELER ST
SAVANNAH GA
31405-5700
US

IV. Provider business mailing address

2 WHEELER ST
SAVANNAH GA
31405-5700
US

V. Phone/Fax

Practice location:
  • Phone: 912-353-7744
  • Fax: 912-355-9124
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number85519
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: