| Frontline Internal Medicine Llc | |
|
6 Lester Rd Statesboro GA 30458-4786 | |
| (912) 681-8999 | |
| (912) 681-8989 |
| Full Name | Frontline Internal Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6 Lester Rd, Statesboro, Georgia |
| Authorized Official Name and Position | Ogechi H Mbakwe (SOLO OWNER) |
| Authorized Official Contact | 9126818999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Frontline Internal Medicine Llc Po Box 1489 Statesboro GA 30459-1489 Ph: (912) 681-8999 | Frontline Internal Medicine Llc 6 Lester Rd Statesboro GA 30458-4786 Ph: (912) 681-8999 |
| NPI Number | 1710328331 |
|---|---|
| Provider Enumeration Date | 07/11/2013 |
| Last Update Date | 10/04/2022 |
| Medicare PECOS PAC ID | 6305088741 |
|---|---|
| Medicare Enrollment ID | O20130814000206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710328331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 69221 (Georgia) | Primary |
| Provider Name | Ogechi H Mbakwe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992861603 PECOS PAC ID: 1355444639 Enrollment ID: I20130814000254 |
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