NPI age
18 years
Enumerated 2007-05-28
Across 221 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (IA) | ENROLLED | |
| 05 (MN) | ENROLLED | |
| 01 (MN) | P00977686 | RAIL ROAD - MEDICARE |
| 05 (WI) | ENROLLED |
Part of a multi-provider practice. 29 other active providers share this practice address in NPPES.
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