NPI age
19 years
Enumerated 2006-10-03
Across 1389 active surgery providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | GRP2383 | GROUP IDENTIFIER |
| 01 (GA) | 030737 | LICENSE |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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