NPI age
20 years
Enumerated 2005-11-29
Across 539 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00645147C | |
| 01 | 2999766 | GHI |
| 01 (GA) | 202I294296 | MEDICARE PTAN |
| 01 (GA) | 290012142 | RAILROAD MEDICARE |
| 01 | 5341107 | AETNA |
| 01 (GA) | 58-1831482 | FEDERAL TAX IDENTIFICATION NUMBER |
| 01 (GA) | 767305 | BLUE CROSS BLUE SHIELD |
| 01 (GA) | 0932200001 | WORKERS COMPENSATION |
| 01 (GA) | 5932 | KAISER |
| 01 | 6054810006 | CIGNA |
| 01 | 4820111 | UNITED HEALTHCARE |
Part of a multi-provider practice. 178 other active providers share this practice address in NPPES.
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