NPI age
14 years
Enumerated 2011-09-20
Across 5027 active internal medicine providers in Georgia.
7 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | 24080 | MEDICARE - PTAN |
| 01 (WY) | 8586A | WYOMING MEDICAL BOARD |
| 01 | 1841597770 | NPI |
| 01 (WY) | 222NSU11 | WYOMING BOARD OF PHARMACY |
| 01 (GA) | 66835 | GEORGIA COMPOSITE BOARD OF MEDICINE |
Multi-provider organization. 7 individual providers on file at this primary address.
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