NPI age
19 years
Enumerated 2006-09-08
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 | 581476757 | COMMERCIAL |
| 05 (GA) | 000153139-B | |
| 01 | 0400527 | UNITED HEALTHCARE |
| 01 | G17877 | SC MEDICAID |
| 01 | 010270 | BCBS |
| 01 | 581476757 | CHAMPUS |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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