NPI age
19 years
Enumerated 2006-08-18
Across 483 active pathology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 91306 | GEORGIA MEDICAL LICENSE |
| 01 (OH) | 35.122076 | OHIO MEDICAL LICENSE |
Part of a multi-provider practice. 1593 other active providers share this practice address in NPPES.
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