Basic Information
| Provider Information | |||||||||
| NPI: | 1558394627 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRICHEVER | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 219 WILEY BOTTOM RD | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314111536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9125982126 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 109 MINIS AVE | ||||||||
| Address2: | SUITE C-10 | ||||||||
| City: | GARDEN CITY | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314082128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9129665445 | ||||||||
| FaxNumber: | 9129665955 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2006 | ||||||||
| LastUpdateDate: | 11/17/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 049048 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.