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NPI Code Detail

MEDICARE: ST CLAIRE GITAU SUMAILI M.D.

MEDICARE: ST CLAIRE GITAU SUMAILI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician074538GA

General Provider Information

NPI Number : 1275911828
Entity Type Code : Individual
Provider Name (Legal Business Name) : ST CLAIRE GITAU SUMAILI M.D.
Provider Business Mailing Address
First Line : 2403 OSLER CT STE A
Second Line :
City : ALBANY
State : GA
Zip : 31707-0205
Country : US
Telephone Number : 229-405-6196
Fax Number : 229-261-1334
Provider Business Practice Location Address
First Line : 2403 OSLER CT STE A
Second Line :
City : ALBANY
State : GA
Zip : 31707-0205
Country : US
Telephone Number : 229-405-6196
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2015
Last Update Date : 06/22/2020

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Directions to “ ST CLAIRE GITAU SUMAILI M.D.” Practice Location

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