NPI age
19 years
Enumerated 2006-06-12
Across 77 active pediatrics providers in Georgia.
5 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | G59179 | |
| 05 (GA) | 315942089A | |
| 05 (IL) | 036-091219 |
Part of a multi-provider practice. 538 other active providers share this practice address in NPPES.
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