NPI age
18 years
Enumerated 2007-09-13
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 752201798A | |
| 05 (SC) | G62860 | |
| 01 (GA) | P00758575 | MEDICARE RR |
Part of a multi-provider practice. 16 other active providers share this practice address in NPPES.
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