NPI age
20 years
Enumerated 2005-07-07
Across 5448 active family medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 598379 | BLUE CROSS/BLUE SHIELD # |
| 01 (GA) | 042916 | GEORGIA MEDICAL LICENSE # |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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