NPI age
19 years
Enumerated 2006-11-13
Across 23 active urology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000358531A | |
| 01 (GA) | 343217 | WELL CARE |
| 01 (GA) | 10064319 | AMERIGROUP |
| 01 (GA) | 11D0881495 | TAXONOMY |
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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