NPI age
20 years
Enumerated 2006-04-24
Across 952 active internal medicine providers in Georgia.
3 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (VA) | 010228921 | |
| 01 (GA) | 79064 | GA MED LICENSE |
| 05 (WV) | 3810004136 |
Part of a multi-provider practice. 23 other active providers share this practice address in NPPES.
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