NPI age
19 years
Enumerated 2006-06-16
Across 483 active pathology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (OK) | 100184410A | |
| 01 (OK) | 751465559003 | BCBS |
Solo or small practice. No other active providers share this practice address in NPPES.
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