NPI age
19 years
Enumerated 2007-02-12
Across 2726 active pediatrics providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 | 37544 | AMERICAN BOARD PEDIATRICS |
| 05 (AL) | 009962415 | |
| 01 | 926662 | AAP ID |
| 05 (AL) | 009962405 | |
| 01 (AL) | 515-22781 | BCBS AL PROV # OPELIKA |
| 01 (AL) | 25967 | ALABAMA CONTR SUBST CERT |
| 01 (AL) | 515-22782 | BCBS AL PROV # AUBURN |
| 01 (AL) | 25967 | ALABAMA MEDICAL LICENSE |
| 01 (GA) | 54982 | GEORGIA MEDICAL LICENSE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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