NPI age
19 years
Enumerated 2006-08-12
Across 5448 active family medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (FL) | 274065600 | |
| 01 (FL) | 30712 | BCBS |
| 01 | P00387710 | RAILROAD MEDICARE |
Part of a multi-provider practice. 17 other active providers share this practice address in NPPES.
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