NPI age
18 years
Enumerated 2007-06-18
Across 47 active obstetrics & gynecology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 057169 | GEORGIA STATE LICENSES |
| 05 (GA) | 616316896E | |
| 05 (GA) | 616316896A | |
| 01 (GA) | 16BBDLX | MEDICARE |
| 05 (GA) | 616316896C | |
| 05 (GA) | 616316896D |
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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