NPI age
19 years
Enumerated 2007-04-03
Across 2726 active pediatrics providers in Georgia.
6 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 178218352B | |
| 01 (GA) | 530894 | WELLCARE |
| 05 (GA) | 178218352C | |
| 01 (GA) | 453382 | WELLCARE |
| 01 (GA) | 8974812 | CIGNA |
| 05 (GA) | 178218352A | |
| 05 (GA) | 178218352D | |
| 05 (GA) | 178218352E | |
| 01 (GA) | 453415 | WELLCARE |
| 01 (GA) | 9806158 | AETNA |
| 01 (GA) | 582117020 | TRICARE |
| 01 (GA) | 582117020024 | TRICARE |
| 01 (GA) | 01184316 | AMERIGROUP |
| 01 (GA) | 453429 | WELLCARE |
| 01 (GA) | 582117020018 | TRICARE |
| 01 (GA) | 582117020030 | TRICARE |
| 01 (GA) | 453425 | WELLCARE |
| 01 (GA) | 52245265 | BCBS |
Part of a multi-provider practice. 151 other active providers share this practice address in NPPES.
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