NPI age
20 years
Enumerated 2006-01-24
Across 108 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (SC) | GPA605 | MEDICAID GROUP ID |
| 05 (SC) | G31082 | |
| 01 (GA) | P00386140 | RR MEDICARE |
| 05 (GA) | 000478937J | |
| 01 (GA) | 01037218 | AMERIGROUP |
| 01 (GA) | 367271 | WELLCARE |
| 01 (GA) | GRP3905 | MEDICARE GROUP ID |
Part of a multi-provider practice. 39 other active providers share this practice address in NPPES.
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