NPI age
20 years
Enumerated 2005-07-14
Across 2726 active pediatrics providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 010183 | BCBS |
| 05 (SC) | G51733 | |
| 01 (GA) | 370021486 | RR MEDICARE |
| 05 (GA) | 000966897A | |
| 05 (GA) | 000966897B |
Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.
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