Sylva Al-Soudi, MD
Individual provider Active NPI Family Medicine Physician · Augusta, GA
NPI 1104043488 · NPPES record last updated Mar 28, 2016
Key facts
- NPI
- 1104043488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 26910 (SC)
- Practice address
- 1 Freedom Way
Augusta, GA 30904-6258 - Phone
- (706) 733-0188
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180322002034 | SC | Order and Referring Only - Family Practice |
2365517075 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26910 | SC | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 26910 | SC | Yes |
Addresses
Primary practice location
1 Freedom Way
Augusta, GA 30904-6258
Mailing address
1 Freedom Way
Augusta, GA 30904-6258
Phone (706) 733-0188
Other providers in Augusta, GA
- James Zachary Akins
- Toni Akiti
- Blessing Adanna Chiamaka Akomas
- Fadi Al Farawati
- Dania Al Jabri
- Alan S Black MD PC
- Hossain Alavi
- Erica D Albea
- John Calvin Alberty
- Andrea Solley Albright
All providers in Augusta, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.