NPI age
19 years
Enumerated 2006-06-26
Across 4616 active physician assistant providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 877965428C | |
| 05 (GA) | GRP1372 | |
| 01 (GA) | P00316602 | RR MEDICARE |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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