NPI age
19 years
Enumerated 2006-09-26
Across 661 active general practice providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (MD) | 10045469 | AMERIGROUP |
| 01 | 00171509D | PEACH STATE HEALTH PLAN |
| 01 | 297125 | WELLCARE |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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