NPI age
16 years
Enumerated 2010-05-10
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (CA) | 639690 | MEDICAL LICENSE PHYSICIAN & SURGEON |
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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