NPI age
19 years
Enumerated 2006-11-13
Across 602 active clinic/center providers in Georgia.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 51005007-002 | BLUE CROSS-BLUE SHIELD |
| 01 (GA) | 069-279 | STATA LICENSE |
Multi-provider organization. 1 individual provider on file at this primary address.
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