NPI age
20 years
Enumerated 2005-10-31
Across 952 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 341954 | WELLCARE |
| 01 (GA) | 702624 | BCBS |
| 01 (GA) | 10062274 | AMERIGROUP |
| 05 (GA) | 000891866A |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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