Healthcare Provider Details

I. General information

NPI: 1033139050
Provider Name (Legal Business Name): ANDREAS SCHILLING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 WATERS AVE
SAVANNAH GA
31404-6220
US

IV. Provider business mailing address

PO BOX 14185
SAVANNAH GA
31416-1185
US

V. Phone/Fax

Practice location:
  • Phone: 912-350-8436
  • Fax:
Mailing address:
  • Phone: 912-898-0536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number22335
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number23387
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number33206
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number058004
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier10068472
Identifier TypeOTHER
Identifier StateGA
Identifier IssuerAMERIGROUP
# 2
Identifier223350
Identifier TypeMEDICAID
Identifier StateSC
Identifier Issuer
# 3
Identifier116825376A
Identifier TypeOTHER
Identifier StateGA
Identifier IssuerPEACH STATE HEALTH PLAN
# 4
IdentifierN347033
Identifier TypeOTHER
Identifier StateGA
Identifier IssuerWELLCARE
# 5
Identifier116825376A
Identifier TypeMEDICAID
Identifier StateGA
Identifier Issuer
# 6
IdentifierP00340688
Identifier TypeOTHER
Identifier StateGA
Identifier IssuerRAILROAD MEDICARE
# 7
Identifier52212349001
Identifier TypeOTHER
Identifier StateGA
Identifier IssuerBCBS
# 8
Identifier013276400
Identifier TypeMEDICAID
Identifier StateFL
Identifier IssuerFlorida Medicaid Provider ID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: