NPI age
19 years
Enumerated 2006-07-12
Across 2726 active pediatrics providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (WV) | 0107371001 | |
| 05 (GA) | 577573746C |
Solo or small practice. No other active providers share this practice address in NPPES.
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