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General NPI Number Information
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NPI Number | 1770839607
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Entity Type | Organization
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Legal Business Name | SANDRA L. MAGER, M.D.P.C.
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 114 W. CHERRY STREET
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City | JESUP
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State | GA
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Zip | 31545
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Country | US
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Telephone | 912-588-1020
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Fax | 912-588-1002
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Provider Business Mailing Address
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Address Line | 114 W. CHERRY STREET
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City | JESUP
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State | GA
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Zip | 31545
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Country | US
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Telephone | 912-588-1020
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Fax | 912-588-1002
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Authorized Official
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Title or Position | PHYSICIAN
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Name | SANDRA MAGER
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Credential | M.D.
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Telephone | 912-588-1020
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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 | 38043
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License Number State | GA
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