NPI age
18 years
Enumerated 2007-06-13
Across 563 active urology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | GRP6913 | MEDICARE GROUP PTAN |
| 01 (GA) | 202I348149 | MEDICARE PTAN |
| 01 | BP2-0026711 | INSTITUTIONAL PERMIT |
Part of a multi-provider practice. 11 other active providers share this practice address in NPPES.
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