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General NPI Number Information
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NPI Number | 1487694261
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Entity Type | Organization
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Legal Business Name | GEORGIA ESOTERIC & MOLECULAR LABS, LLC
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 09/19/2016
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Provider Practice Location Address
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Address Line | 1120 15TH ST ROOM BF-207
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City | AUGUSTA
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State | GA
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Zip | 30912-0004
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Country | US
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Telephone | 706-721-5116
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Fax | 706-721-5117
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Provider Business Mailing Address
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Address Line | 1120 15TH ST ROOM BF-207
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City | AUGUSTA
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State | GA
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Zip | 30912-0004
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Country | US
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Telephone | 706-828-6410
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Fax | 706-722-5187
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | CURT M. STEINHART
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Credential | M.D.
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Telephone | 706-828-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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