NPI age
19 years
Enumerated 2007-02-21
Across 2726 active pediatrics providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 907907838C | |
| 05 (TN) | 1513136 |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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