Healthcare Provider Details

I. General information

NPI: 1689619033
Provider Name (Legal Business Name): NATALIE MENENDEZ HOGAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 01/24/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 WATERS AVE
SAVANNAH GA
31404-6220
US

IV. Provider business mailing address

4700 WATERS AVE
SAVANNAH GA
31404-6220
US

V. Phone/Fax

Practice location:
  • Phone: 912-350-8180
  • Fax: 912-350-7221
Mailing address:
  • Phone: 912-350-8180
  • Fax: 912-350-7221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number042283
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: