NPI age
19 years
Enumerated 2007-05-24
Across 643 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (LA) | 4M936F600 | MEDICARE - PTAN |
| 05 (LA) | 1071676 |
Part of a multi-provider practice. 36 other active providers share this practice address in NPPES.
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