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General NPI Number Information
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NPI Number | 1093702540
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Entity Type | Individual
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Provider Name | HUBERT MCCRARY SUBER MD
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Gender | Male
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 03/03/2015
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Provider Practice Location Address
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Address Line | 101 HARRIS INDUSTRIAL BLVD SUITE C
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City | VIDALIA
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State | GA
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Zip | 30474-8852
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Country | US
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Telephone | 912-537-1014
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Fax | 912-538-1538
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Provider Business Mailing Address
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Address Line | PO BOX 407
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City | VIDALIA
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State | GA
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Zip | 30475-0407
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Country | US
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Telephone | 912-537-4986
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Fax | 912-538-8166
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 024730
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License Number State | GA
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