Live Healthy MD LLC

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

40826 Issued in GA

Legal business name

LIVE HEALTHY MD LLC

Practice address

3830 Washington Rd
Ste 17
Augusta, GA 30907-5064

Phone

(706) 922-0440

Fax

(706) 922-0441

NPI assigned

Jan 19, 2012

Organization subpart

Yes

Parent organization

LIVE HEALTHY MD LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Edward H Boland, MD

Title

Physician

Phone

(706) 922-0440

Specialties & licenses 1

Addresses

Part of

Live Healthy MD LLC

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327881600000",
    "number": "1447521661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 CENTRAL AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046706",
            "telephone_number": "706-738-3359",
            "fax_number": "706-738-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 WASHINGTON RD",
            "address_2": "STE 17",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309075064",
            "telephone_number": "706-922-0440",
            "fax_number": "706-922-0441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE HEALTHY MD LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIVE HEALTHY MD LLC",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-01-30",
        "status": "A",
        "authorized_official_last_name": "BOLAND",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "706-922-0440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "GA",
            "license": "40826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preventive Medicine/Occupational Environmental Medicine Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.