NPI age
19 years
Enumerated 2007-05-15
Across 483 active pathology providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 460052 | WELLCARE |
| 05 (GA) | 268886060A | |
| 01 (GA) | 1366658437 | TRICARE |
| 05 (FL) | 127019900 |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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