NPI age
20 years
Enumerated 2006-02-15
Across 5448 active family medicine providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000373898U | |
| 05 (GA) | 000373898S | |
| 01 (GA) | 01158097 | AMERIGROUP |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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