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General NPI Number Information
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NPI Number | 1912326893
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY CONSULTANTS OF SAVANNAH, PC
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Dates
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Enumeration Date | 04/08/2014
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 12 ARLEY WAY STE 103B
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City | BLUFFTON
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State | SC
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Zip | 29910-8860
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Country | US
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Telephone | 912-354-9447
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Fax |
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Provider Business Mailing Address
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Address Line | 519 STEPHENSON AVE
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City | SAVANNAH
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State | GA
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Zip | 31405-5969
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Country | US
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Telephone | 912-354-9447
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Fax | 912-355-6430
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Authorized Official
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Title or Position | MD
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Name | GREGORY D BORAK
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Credential |
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Telephone | 912-354-9447
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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 | 25219085
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License Number State | GA
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