NPI age
19 years
Enumerated 2006-08-31
Across 1881 active specialist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 699850421A | |
| 01 (GA) | 10061954 | AMERIGROUP PROVIDER # |
| 01 (GA) | 336419 | WELLCARE |
| 01 (GA) | 33619 | WELLCARE HEALTH PLAN |
Single-site organization. Only one practice location on file.
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