Provider Demographics
NPI:1750607222
Name:GUNKEL CARDIOLOGY GROUP, LLC
Entity type:Organization
Organization Name:GUNKEL CARDIOLOGY GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIETER
Authorized Official - Middle Name:K
Authorized Official - Last Name:GUNKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-721-2900
Mailing Address - Street 1:11702 MERCY BLVD
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-1750
Mailing Address - Country:US
Mailing Address - Phone:912-721-2900
Mailing Address - Fax:912-721-2903
Practice Address - Street 1:11702 MERCY BLVD
Practice Address - Street 2:SUITE 2D
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1750
Practice Address - Country:US
Practice Address - Phone:912-721-2900
Practice Address - Fax:912-721-2903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA14247207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty