Healthcare Provider Details

I. General information

NPI: 1770028557
Provider Name (Legal Business Name): CENTER FOR DIGESTIVE AND LIVER HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2017
Last Update Date: 01/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 OKATIE CENTER BLVD S SUITE 210
OKATIE SC
29909-7507
US

IV. Provider business mailing address

1139 LEXINGTON AVE
SAVANNAH GA
31404-5502
US

V. Phone/Fax

Practice location:
  • Phone: 912-303-4200
  • Fax: 912-790-2701
Mailing address:
  • Phone: 912-303-4200
  • Fax: 912-790-2701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: LYNNE MARINI
Title or Position: CEO
Credential:
Phone: 912-790-2696