Provider Demographics
NPI:1568271393
Name:PRIMAS, VICTOR
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:
Last Name:PRIMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CLUB CT
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-7537
Mailing Address - Country:US
Mailing Address - Phone:443-866-9184
Mailing Address - Fax:
Practice Address - Street 1:202 CLUB CT
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-7537
Practice Address - Country:US
Practice Address - Phone:443-866-9184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA24224553251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health