NPI age
19 years
Enumerated 2006-11-13
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000758172N | |
| 01 (GA) | 110238633 | RAIL ROAD MEDICARE |
| 01 (GA) | 52597384 011 | BCBS PROVIDER # |
| 01 (GA) | 000758172N | PEACH STATE PROVIDER # |
| 01 (GA) | 319589 | WELL CARE PROVIDER # |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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