NPI age
19 years
Enumerated 2006-06-02
Across 5448 active family medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 52260821-001 | BLUE CROSS BLUE SHIELD PROVIDER ID |
| 01 | 1568628618 | GROUP NPI |
| 01 (GA) | 4073314 | AETNA PROVIDER ID |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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