NPI age
20 years
Enumerated 2006-03-21
Across 1881 active specialist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 85002467G | |
| 05 (AL) | 009935280 | |
| 05 (GA) | 00364889C | |
| 01 (GA) | 582557935 | TAX ID |
| 01 (GA) | 085352 | BCBS |
| 05 (AL) | 529909780 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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