Abby Tubman Abisogun, M.D.
Individual provider Active NPI Endocrinology, Diabetes & Metabolism Physician · Savannah, GA
NPI 1891088985 · NPPES record last updated Dec 10, 2021
Key facts
- NPI
- 1891088985
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician 207RE0101X
- License
- 080802 (GA)
- Practice address
- 7505 Waters Ave Ste A9
Savannah, GA 31406-3817 - Phone
- (912) 483-9313
- Fax
- (912) 446-0549
- NPI assigned
- May 23, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2022 through Jan 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP02225 | RI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southcoast Medical Group, LLC | Internal Medicine | Past |
Accepting new patients |
Interoperability endpoints
- abby.abisogun@377489416454148.direct.elationemr.com
- abby.abisogun.1@8042.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | LP02225 | RI | |
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 2016-00460 | NC | |
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 080802 | GA | Yes |
Addresses
Primary practice location
7505 Waters Ave Ste A9
Savannah, GA 31406-3817
Mailing address
7505 Waters Ave Ste A9
Savannah, GA 31406-3817
Phone (912) 483-9313
Other providers in Savannah, GA
- Abercorn Family Medical Center
- Abercorn Rehabilitation Center, LLC
- Amy Suzanne Abernathy
- Janice Elise Abernathy
- Lindsay T Abernethy
- Akinniran Adedamola Abisogun
- Julia Ableitner
- Ablemed Supply
- Marcus Abrams
- Adel Abdedhamid Abuelazm Sr.
All providers in Savannah, GA · Endocrinology, Diabetes & Metabolism 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 Dec 10, 2021. 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).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.