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NPI Code Detail

MEDICARE: SERITA CONAWAY

MEDICARE: SERITA CONAWAY
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1861920605
Entity Type Code : Individual
Provider Name (Legal Business Name) : SERITA CONAWAY
Provider Business Mailing Address
First Line : 2100 COMER AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-8725
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1727 BOXWOOD PL
Second Line :
City : COLUMBUS
State : GA
Zip : 31906-2328
Country : US
Telephone Number : 706-596-5983
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2017
Last Update Date : 05/24/2017

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Directions to “ SERITA CONAWAY ” Practice Location

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