Provider Demographics
NPI:1801384664
Name:MABE, MICAH LOGAN (MD)
Entity type:Individual
Prefix:
First Name:MICAH
Middle Name:LOGAN
Last Name:MABE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4700 WATERS AVE BLDG 400
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6220
Mailing Address - Country:US
Mailing Address - Phone:912-350-3438
Mailing Address - Fax:912-350-9037
Practice Address - Street 1:4700 WATERS AVE BLDG 400
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6220
Practice Address - Country:US
Practice Address - Phone:912-350-3438
Practice Address - Fax:912-350-9037
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2024-10-25
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Provider Licenses
StateLicense IDTaxonomies
GA100854208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery