NPI age
17 years
Enumerated 2008-11-19
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 20211I5698 | MEDICARE |
| 05 (GA) | 799298449D | |
| 01 (GA) | 070247 | GA MEDICAL LICENSE |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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