Richard M Proenza is a Surgical in Vidalia, Georgia. Richard M Proenza practices all healthcare services and medical treatments related to Surgical. The NPI Number for Richard M Proenza is 1982693024. The last update date is 2013-10-03.
Richard M Proenza's current location address is 3301 E 1st St, Vidalia, Georgia. You can contact this provider via phone number 9125374411 and fax number 9125388485. The mailing address for Richard M Proenza is 3301 E 1st St, Vidalia, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Richard M Proenza |
|---|---|
| Address | 3301 E 1st St, Vidalia, Georgia |
| Phone Number | 9125374411 |
| Fax Number | 9125388485 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1982693024 |
|---|---|
| Provider Enumeration Date | 2005-10-20 |
| Last Updated Date | 2013-10-03 |
Provider Mailing Address Detail
| Address | 3301 E 1st St |
|---|---|
| City | Vidalia |
| State | Georgia (GA) |
| Post Code | 304748674 |
| Phone Number | 9125374411 |
| Fax Number | 9125388485 |
Provider's Primary Taxonomy Detail
| Speciality | Surgical |
|---|---|
| Taxonomy | 363As0400X |
| Licence No | 4304 |
|
Definition: A licensed healthcare professional who assists in providing surgical care under physician supervision. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 954937257E | GA | -- | |
| 954937257F | GA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Richard M Proenza by the Centers for Medicare & Medicaid Services?
The Richard M Proenza has been issued the NPI (National Provider Identifier) 1982693024, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Richard M Proenza?
The Richard M Proenza is situated at 3301 E 1St St, in the city of Vidalia, state of GA, with the zip code 304748674.
What is the Richard M Proenza's area of specialization and corresponding taxonomy classification?
The Richard M Proenza's specialty field is Surgical, and it falls under the taxonomy code 363As0400X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1982693024 to Richard M Proenza?
The Richard M Proenza received its 1982693024 assignment from the Centers for Medicare & Medicaid Services on 2005-10-20.
When was the information related to Richard M Proenza most recently updated or refreshed?
The details pertaining to the Richard M Proenza, including its address, specialty, and other relevant information, were last updated or refreshed on 2013-10-03.
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