Provider Demographics
NPI:1215153614
Name:INTERNAL MEDICINE & ENDOCRINE ASSOCIATES OF AUGUSTA,P.C.
Entity type:Organization
Organization Name:INTERNAL MEDICINE & ENDOCRINE ASSOCIATES OF AUGUSTA,P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:RYCHLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-722-0463
Mailing Address - Street 1:820 SAINT SEBASTIAN WAY
Mailing Address - Street 2:SUITE 7A
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2643
Mailing Address - Country:US
Mailing Address - Phone:706-722-0463
Mailing Address - Fax:
Practice Address - Street 1:820 SAINT SEBASTIAN WAY
Practice Address - Street 2:SUITE 7A
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2643
Practice Address - Country:US
Practice Address - Phone:706-722-0463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1689729055OtherCOUNSELL
1942355342OtherELCHOUFI
1093868762OtherRYCHLY
1295880680OtherHERSKOWITZ
1669527156OtherLEMKE
CA5819OtherRAILROAD GROUP NUMBER
1295880680OtherHERSKOWITZ
1669527156OtherLEMKE