NPI age
19 years
Enumerated 2006-08-22
Across 77 active pediatrics providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (PA) | 1012277730 | |
| 01 (PA) | 089852EMD | MEDICARE PTAN |
Part of a multi-provider practice. 185 other active providers share this practice address in NPPES.
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