NPI age
20 years
Enumerated 2005-12-30
Across 1881 active specialist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000117719G | |
| 05 (GA) | 000117719D | |
| 05 (GA) | 000117719E |
Part of a multi-provider practice. 36 other active providers share this practice address in NPPES.
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