Provider Demographics
NPI:1427097385
Name:CADY, MARY I (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:I
Last Name:CADY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4451 PAULSEN ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-3664
Mailing Address - Country:US
Mailing Address - Phone:912-350-7500
Mailing Address - Fax:912-350-7735
Practice Address - Street 1:4451 PAULSEN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-3664
Practice Address - Country:US
Practice Address - Phone:912-350-7500
Practice Address - Fax:912-350-7735
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA019647207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA110214428OtherRAILROAD MEDICARE
GA000285183EMedicaid
GA619143OtherWELLCARE
SCG19647Medicaid
GA000285183GMedicaid
GA349733OtherWELLCARE
GA000285183HMedicaid
GA10063577OtherAMERIGROUP
GA000285183GMedicaid
GA000285183EMedicaid