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General NPI Number Information
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NPI Number | 1992802342
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Entity Type | Individual
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Provider Name | JIMMY ARTURO MALAVER-REYES M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 214 PROFESSIONAL CIR STE A
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City | SAINT MARYS
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State | GA
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Zip | 31558-3783
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Country | US
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Telephone | 787-605-8830
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Fax |
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Provider Business Mailing Address
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Address Line | 214 PROFESSIONAL CIR STE A
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City | SAINT MARYS
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State | GA
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Zip | 31558-3783
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Country | US
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Telephone | 904-588-2001
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Fax | 912-576-4791
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 65138
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License Number State | GA
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