| Ergent Med Prime | |
|
5248 New Jesup Hwy Brunswick GA 31523-1211 | |
| (912) 264-1883 | |
| Not Available |
| Full Name | Ergent Med Prime |
|---|---|
| Speciality | Clinic/Center |
| Location | 5248 New Jesup Hwy, Brunswick, Georgia |
| Authorized Official Name and Position | James R Cutia (OWNER/PARTNER) |
| Authorized Official Contact | 9122641883 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ergent Med Prime 5248 New Jesup Hwy Brunswick GA 31523-1211 Ph: () - | Ergent Med Prime 5248 New Jesup Hwy Brunswick GA 31523-1211 Ph: (912) 264-1883 |
| NPI Number | 1811345390 |
|---|---|
| Provider Enumeration Date | 05/25/2016 |
| Last Update Date | 05/25/2016 |
| Medicare PECOS PAC ID | 8820362189 |
|---|---|
| Medicare Enrollment ID | O20170925003644 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811345390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Michael K Hamm |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942275425 PECOS PAC ID: 1658364039 Enrollment ID: I20040405000054 |
| Provider Name | Candice Dutka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376011676 PECOS PAC ID: 4789920463 Enrollment ID: I20190118000400 |
| Provider Name | Gabrel Matthew Crabb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134690555 PECOS PAC ID: 2062754401 Enrollment ID: I20190503001558 |
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