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VANITCHA R PINTAVORN MD

Allergy

Evans, Georgia

Provider NPI: 1215931555

Provider Information:
 VANITCHA R PINTAVORN MD


Practice Location:
418 TOWN PARK BLVD SUITE 1A EVANS, GA 30809 US
Tel: 706-650-1662  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207KA0200XPhysicians
Allergy & Immunology
Allergy
GA048291

Other Provider Identifiers:

IssuerNumberStateType
G48291SC05
000894154DGA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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