NPI age
12 years
Enumerated 2013-07-01
Across 1389 active surgery providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | 360854 | |
| 01 (SC) | SCD5146121 | MEDICARE PIN |
| 01 (SC) | SCD5147628 | MEDICARE PIN |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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