MEDICARE: DR. GUY RUEDAS MACLANG MD

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
1	207R00000X	Internal Medicine Physician	57534	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	189912	OTHER	NC	MEDCOST ID
2	7681859	OTHER	NC	AETNA ID
3	6149376	OTHER	NC	CIGNA ID
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	5703177	OTHER	NC	FIRST HEALTH ID
6	142TU	OTHER	NC	BC/BS ID

General Provider Information

NPI Number	:	1417900234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GUY RUEDAS MACLANG MD

Provider Business Mailing Address
First Line	:	PO BOX 15849
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31416-2549
Country	:	US
Telephone Number	:	912-303-3552
Fax Number	:	912-303-3506

Provider Business Practice Location Address
First Line	:	5354 REYNOLDS ST STE 424
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-6011
Country	:	US
Telephone Number	:	912-819-5999
Fax Number	:	912-819-5980

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	10/29/2020

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Directions to “ DR. GUY RUEDAS MACLANG MD” Practice Location

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