Provider Demographics
NPI:1992763627
Name:STERLING EMERGENCY SERVICES OF THE SOUTHEAST INC
Entity type:Organization
Organization Name:STERLING EMERGENCY SERVICES OF THE SOUTHEAST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN/PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUNKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-805-1300
Mailing Address - Street 1:PO BOX 532735
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-2735
Mailing Address - Country:US
Mailing Address - Phone:904-805-1300
Mailing Address - Fax:904-805-1456
Practice Address - Street 1:101 LAKE OCONEE PKWY
Practice Address - Street 2:
Practice Address - City:EATONTON
Practice Address - State:GA
Practice Address - Zip Code:31024-6054
Practice Address - Country:US
Practice Address - Phone:706-485-2711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========045OtherCHAMPUS
GA=========049OtherCHAMPUS
GA=========057OtherCHAMPUS
GA=========049OtherCHAMPUS
FLGRP2442Medicare PIN