NPI age
19 years
Enumerated 2006-08-10
Across 437 active podiatrist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (SC) | 205284392 | TAX ID SC |
| 05 (GA) | 000927011C |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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