NPI age
19 years
Enumerated 2006-09-27
Across 437 active podiatrist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000750439O | |
| 01 (GA) | 814 | STATE ID |
| 01 (GA) | 202I501203 | MEDICARE PTAN |
Part of a multi-provider practice. 26 other active providers share this practice address in NPPES.
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