Annamma T Mammen, MD | |
1120 15th St, Augusta, GA 30912-0004 | |
(706) 721-4588 | |
(706) 721-7264 |
Full Name | Annamma T Mammen |
---|---|
Gender | Female |
Speciality | Family Medicine |
Location | 1120 15th St, Augusta, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376652453 | NPI | - | NPPES |
000544475A | Medicaid | GA | |
G36652 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036652 (Georgia) | Primary |
Entity Name | Au Medical Associates Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841230620 PECOS PAC ID: 9931013513 Enrollment ID: O20040107000188 |
Mailing Address | Practice Location Address |
---|---|
Annamma T Mammen, MD 1499 Walton Way, Ste 1400, Augusta, GA 30901-2602 Ph: (706) 828-6410 | Annamma T Mammen, MD 1120 15th St, Augusta, GA 30912-0004 Ph: (706) 721-4588 |
Dr. Toya Hester Kelley, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-3157 | |
Janis S. Coffin, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-4588 Fax: 706-721-7264 | |
Dr. Thomas Christopher Smith, M.D. Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 1701 Magnolia Way Ste 101, Augusta, GA 30909 Phone: 706-922-6600 Fax: 706-650-0239 | |
Dr. William Robert Rout, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 963 Bennock Mill Dr., Augusta, GA 30906 Phone: 352-538-5899 | |
Racquel Puranda, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 678-790-0634 | |
Angela Overstreet Wright, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2607 Commons Blvd, Augusta, GA 30909 Phone: 706-750-8601 | |
Shahed Anam Ibn Faruk, Family Medicine Medicare: Medicare Enrolled Practice Location: 1120 15th St, Augusta, GA 30912 Phone: 706-721-2273 |