NPI age
20 years
Enumerated 2006-04-18
Across 562 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | 282651 | |
| 01 (SC) | 043723466 | TRICARE PROVIDER NUMBER |
| 01 (SC) | 7409727 | AETNA PROVIDER NUMBER |
Part of a multi-provider practice. 13 other active providers share this practice address in NPPES.
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