NPI age
19 years
Enumerated 2007-03-28
Across 55 active dermatology providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (MI) | 07-0220028-2 | BCBS MI |
| 01 (MI) | P00799113 | RR MEDICARE |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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