NPI age
20 years
Enumerated 2005-11-21
Across 494 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003208629A | |
| 01 (GA) | 80969 | LICENSE |
Part of a multi-provider practice. 153 other active providers share this practice address in NPPES.
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