NPI age
19 years
Enumerated 2006-08-07
Across 494 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 466626 | WELLCARE |
| 01 (GA) | 462494632 | FEDERAL TAX ID |
| 05 (GA) | 267747624A |
Part of a multi-provider practice. 11 other active providers share this practice address in NPPES.
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