NPI age
14 years
Enumerated 2012-04-03
Across 1893 active obstetrics & gynecology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 300034164A | |
| 01 (NY) | 283578 | NYS MEDICAL LICENSE |
| 01 (GA) | GRP3569 | MEDICARE OPTOUT |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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