NPI age
19 years
Enumerated 2006-07-14
Across 562 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000779369G | |
| 01 (GA) | 202I395238 | MEDICARE PTAN |
Part of a multi-provider practice. 26 other active providers share this practice address in NPPES.
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