NPI age
19 years
Enumerated 2006-07-26
Across 952 active internal medicine providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | G20623 | |
| 05 (GA) | 00179077D | |
| 01 (GA) | 1585885-004 | CIGNA |
| 01 | 4134155 | AETNA PPO |
| 01 (GA) | 595429 | BCBS |
| 01 | 897824 | AETNA HMO |
Part of a multi-provider practice. 46 other active providers share this practice address in NPPES.
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