NPI age
19 years
Enumerated 2006-11-07
Across 1881 active specialist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 10055949 | AMERIGROUP ID |
| 05 (GA) | 914888852A |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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