NPI age
20 years
Enumerated 2006-05-19
Across 2726 active pediatrics providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000784869F | |
| 01 (GA) | 52672830-004 | BCBS |
| 01 | 104279 | PEACHSTATE |
| 01 (AL) | 135331 | BCBS |
| 01 | 433907 | WELLCARE |
Part of a multi-provider practice. 271 other active providers share this practice address in NPPES.
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