NPI age
19 years
Enumerated 2007-01-29
Across 562 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 71645 | MEDICAL LICENSE |
| 01 (IN) | 01059360A | MEDICAL LICENSE |
Part of a multi-provider practice. 133 other active providers share this practice address in NPPES.
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