NPI age
11 years
Enumerated 2015-04-30
Across 730 active clinic/center providers in Georgia.
6 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | 11885042 | CAQH |
| 05 (GA) | 000897993 | |
| 01 (GA) | 01900609 | AMERIGROUP |
Multi-provider organization. 6 individual providers on file at this primary address.
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