NPI age
20 years
Enumerated 2006-04-14
Across 221 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 479773 | BCBS |
| 01 (GA) | 5249773 | STATE MERIT |
| 01 (GA) | GA0064264 | CHAMPUS |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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