NPI age
20 years
Enumerated 2005-07-14
Across 1881 active specialist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 10034905 | |
| 01 (GA) | 3416408 | AETNA |
| 05 (GA) | 296146 | |
| 05 (GA) | 00408548A |
Part of a multi-provider practice. 43 other active providers share this practice address in NPPES.
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