NPI age
20 years
Enumerated 2005-07-14
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | G40753 | |
| 05 (GA) | 000742783A | |
| 01 (GA) | 650896 | BCBS |
Part of a multi-provider practice. 16 other active providers share this practice address in NPPES.
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