NPI age
20 years
Enumerated 2006-01-18
Across 2726 active pediatrics providers in Georgia.
6 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000702424E | |
| 01 (GA) | 303960 | WELLCARE |
| 01 (GA) | 52023522 | BCBS |
| 01 (GA) | 812104 | AETNA HMO |
| 05 (GA) | 000702424B | |
| 05 (GA) | 000702424D | |
| 01 (GA) | 4250389 | AETNA PPO |
| 01 (GA) | 3206250 | CIGNA |
| 01 (GA) | 1200140 | UNITED HEALTHCARE |
| 01 (GA) | 303970 | WELLCARE |
| 01 (GA) | 10032965 | AMERIGROUP |
| 05 (GA) | 000702424C | |
| 05 (GA) | 000702424A | |
| 01 (GA) | 303971 | WELLCARE |
| 01 (GA) | 303972 | WELLCARE |
Part of a multi-provider practice. 151 other active providers share this practice address in NPPES.
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