NPI age
19 years
Enumerated 2006-12-20
Across 2726 active pediatrics providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000223308B | |
| 01 (GA) | 10065026 | AMERIGROUP |
| 01 (GA) | 37BBFTQ | OLD PTAN, TERM'D DUE TO INACTIVITY |
| 01 (GA) | 349803 | WELLCARE |
| 05 (SC) | G22823 |
Part of a multi-provider practice. 538 other active providers share this practice address in NPPES.
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