NPI age
19 years
Enumerated 2007-01-17
Across 1881 active specialist providers in Georgia.
1 secondary location on file with NPPES.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 021262938A | |
| 05 (GA) | 449810589A |
Multi-provider organization. 1 individual provider on file at this primary address. Plus 1 secondary practice location.
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