NPI age
20 years
Enumerated 2006-04-13
Across 292 active internal medicine providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (FL) | 014539800 | |
| 01 (FL) | 10033 | BCBS |
| 01 (FL) | 1063476364 | TRICARE |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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