NPI age
20 years
Enumerated 2006-05-05
Across 1881 active specialist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000151093K | |
| 05 (AL) | 154326 | |
| 01 (GA) | 202I782712 | MEDICARE PTAN |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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