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General NPI Number Information
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NPI Number | 1619081429
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Entity Type | Organization
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Legal Business Name | DIGESTIVE DISEASE CONSULTANTS, P.C.
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1501 ALICE ST
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City | WAYCROSS
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State | GA
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Zip | 31501-4530
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Country | US
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Telephone | 912-285-0877
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Fax | 912-287-0387
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Provider Business Mailing Address
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Address Line | 1501 ALICE ST
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City | WAYCROSS
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State | GA
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Zip | 31501-4530
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Country | US
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Telephone | 912-285-0877
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Fax | 912-287-0387
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Authorized Official
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Title or Position | OWNER
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Name | SOHAIL A CHOUDHRI
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Credential | M.D.
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Telephone | 912-285-0877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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