NPI age
19 years
Enumerated 2007-03-19
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 35811 | GA STATE LICENSE |
| 01 (OR) | MD27256 | OR STATE LICENSE |
Solo or small practice. No other active providers share this practice address in NPPES.
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