NPI age
12 years
Enumerated 2014-05-01
Across 221 active internal medicine providers in Georgia.
4 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 95074 | GA STATE MEDICAL BOARD |
Part of a multi-provider practice. 495 other active providers share this practice address in NPPES.
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