NPI age
20 years
Enumerated 2005-11-07
Across 1389 active surgery providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 000570534D | MEDICAID |
| 05 (GA) | 839014891 | |
| 01 (GA) | 1487774261 | GROUP NPI |
| 01 (GA) | 386024 | WELLCARE |
| 01 (GA) | 20-5788381 | TAX ID |
| 01 (GA) | GRP8005 | GROUP IDENTIFIER |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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