MEDICARE: REPRODUCTIVE ENDOCRINOLOGISTS, PC

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	207VE0102X	Reproductive Endocrinology Physician	08531	GA

General Provider Information

NPI Number	:	1932398831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REPRODUCTIVE ENDOCRINOLOGISTS, PC

Provider Business Mailing Address
First Line	:	903 15TH ST
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30901-2607
Country	:	US
Telephone Number	:	706-724-8878
Fax Number	:	706-724-3796

Provider Business Practice Location Address
First Line	:	903 15TH ST
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30901-2607
Country	:	US
Telephone Number	:	706-724-8878
Fax Number	:	706-724-3796

Authorized Official
Title or Position	:	OFFICE ADMINISTRATOR
Name	:	BHUVANA NATRAJAN
Credential	:
Telephone Number	:	706-724-8878

Provider Enumeration Date	:	10/17/2007
Last Update Date	:	01/22/2022

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