NPI age
19 years
Enumerated 2007-01-30
Across 138 active pediatrics providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 000236959A | PEACHSTATE MEDICAID |
| 01 (GA) | 336022 | WELLCARE MEDICAID |
| 05 (GA) | 000236959A |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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