DR. FABIO KATUREEBE BANEGURA (NPI# 1114066602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114066602 |
| Entity Type | Individual |
| Full Name | DR. FABIO KATUREEBE BANEGURA |
| Credential | MD |
| Practice Address |
4124 Highway 278 Ne Covington GA 30014-2494 |
| Practice Telephone | 7707865000 |
| Mailing Telephone | 7707865000 |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
021447 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | DEA# | BB0398582 | 01 |
| Street Address |
4124 HIGHWAY 278 NE |
| City | COVINGTON |
| State | GA |
| Zip Code | 30014-2494 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952349334 | Nazir Ahmad Khawaja | Ophthalmology | 4124 Highway 278 Ne, Covington, GA 30014-2494 | 2006-06-04 |
| 1124184908 | Abbanna Health & Rehab Services PC | Physical Therapist | 4124 Highway 278 Ne, Covington, GA 30014-2494 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495635 | Cathy Cassandra Collins | Pharmacist | 3639 Hwy 278, Covington, GA 30014 | 2020-10-22 |
| 1154933877 | Atl Optical LLC | Optometrist | 3135 Highway 278 Ne, Covington, GA 30014 | 2020-08-24 |
| 1932737046 | Samagas House Org | Adult Companion | 1500 Mountain View Cirlcle, Conyers, GA 30014 | 2020-04-01 |
| 1356834360 | Covington Dental Care | Dentist | 4139 Baker Street, Suite 15, Covington, GA 30014 | 2018-06-13 |
| 1487190005 | New Avenues Assessment and Counseling Center LLC | Counselor | 3192 Spring Street, Covington, NEWTON 30014 | 2017-01-07 |
| 1275903973 | Jennifer Carol Bridges | Registered Nurse | 320 Malcom Lane, Covington, GA 30014 | 2015-10-07 |
| 1134598501 | Shelby Boggus King | Physician Assistant | 4181 Hospital Drive Ne, Suite 204, Covington, GA 30014 | 2015-09-16 |
| 1366829814 | Wendy Pazdur | Counselor | 5109 Hwy 278 East, Suite D, Covington, GA 30014 | 2015-05-05 |
| 1306235445 | Covington Center for Family Dentistry | Dentist | 10373 Industrial Blvd, Covington, GA 30014 | 2015-01-13 |
| 1992103428 | Modern Cosmetic Dental Care, LLC | Clinic/Center | 1750 Highway 11, Suite B, Covington, GA 30014 | 2014-12-16 |
| Find all providers in zip 30014 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952499691 | James Ray Rich | Family Medicine | 5975 Taylor Mill Road, Covington, KY 41015-2397 | 2006-10-10 |
| 1942231899 | Philip Y. Chan | Family Medicine | 16850 Se 272nd St, Covington, WA 98042-4931 | 2006-07-06 |
| 1942246418 | Todd S. Bouchard | Family Medicine | 16850 Se 272nd St, Covington, WA 98042-4931 | 2006-06-21 |
| 1871540468 | Public Hospital District #1 of King County | Family Medicine | 16850 Se 272nd St, Covington, WA 98042-4931 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306464250 | Leah Reed | Family Medicine | 2082 Cherokee Farms Cv, Buford, GA 30519-7004 | 2020-07-08 |
| 1083240766 | Carehere LLC | Family Medicine | 114 N Jackson St, Albany, GA 31701-2583 | 2020-03-13 |
| 1518590744 | Octavia Raquel Holloway-freeman | Family Medicine | 301 Denmark St, Statesboro, GA 30458-5208 | 2020-02-17 |
| 1891331575 | Jenna Barnes | Family Medicine | 1107 Memorial Dr Ste 300, Dalton, GA 30720-8664 | 2019-11-18 |
| 1023651205 | Carehere LLC | Family Medicine | 750 S Perry St Ste 200, Lawrenceville, GA 30046-4804 | 2019-10-21 |
| 1003385733 | James G Hamilton Jr Md LLC | Family Medicine | 4898 Highway 197, Mount Airy, GA 30563-2442 | 2018-11-26 |
| 1780161323 | Personal Wellness Inc. | Family Medicine | 625 Boxwood Ter, Johns Creek, GA 30005-7217 | 2018-07-26 |
| 1073005138 | Lake Oconee Wellness Associates LLC | Family Medicine | 1097 Lake Oconee Pkwy Ste 201, Eatonton, GA 31024-9510 | 2018-06-05 |
| 1376034983 | Lee Pennington Mcnichols | Family Medicine | 2300 Bethelview Rd Ste 110-332, Cumming, GA 30040-9475 | 2018-05-21 |
| 1972021301 | Docpecox, LLC | Family Medicine | 755 Mount Vernon Hwy Ne Ste 350, Atlanta, GA 30328-4291 | 2017-09-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. FABIO KATUREEBE BANEGURA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.