NPI age
20 years
Enumerated 2005-11-15
Across 563 active urology providers in Georgia.
3 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (TN) | 4116328 | BCBS |
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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