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NPI Code Detail

MEDICARE: SMH INNOVATIONS LLC

MEDICARE: SMH INNOVATIONS LLC
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 Physician
2207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1689529901
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMH INNOVATIONS LLC
Provider Business Mailing Address
First Line : 463 POOLER PKWY
Second Line : PMB 132
City : POOLER
State : GA
Zip : 31322-5102
Country : US
Telephone Number : 912-349-9671
Fax Number :
Provider Business Practice Location Address
First Line : 800 E 68TH ST
Second Line :
City : SAVANNAH
State : GA
Zip : 31405-4710
Country : US
Telephone Number : 912-349-9671
Fax Number :
Authorized Official
Title or Position : PARTNER
Name : SPIRO MAVROMATES
Credential : MD
Telephone Number : 912-656-1071
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/03/2026

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Directions to “SMH INNOVATIONS LLC ” Practice Location

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