NPI age
19 years
Enumerated 2006-10-16
Across 5448 active family medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000956117B | |
| 01 (GA) | 051586 | GA LICENSE |
Part of a multi-provider practice. 12 other active providers share this practice address in NPPES.
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