NPI age
20 years
Enumerated 2005-10-20
Across 160 active radiology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 30BDMZN | MEDICARE PTAN |
| 01 (AZ) | 81216 | VRL |
| 01 (GA) | 225428377 | MEDICAID BASE # |
| 05 (AZ) | 868284 |
Part of a multi-provider practice. 90 other active providers share this practice address in NPPES.
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