NPI age
20 years
Enumerated 2006-03-21
Across 2726 active pediatrics providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00249257E | |
| 01 (GA) | 1200172 | UNITED HEALTHCARE |
| 01 (GA) | 4084285 | AETNA |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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