NPI age
19 years
Enumerated 2006-06-23
Across 1991 active emergency medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000403807C | |
| 01 (GA) | 623872 | BLUE CROSS |
| 05 (SC) | G31100 | |
| 01 (SC) | G31100 | SOUTH CAROLINA MEDICAID |
Part of a multi-provider practice. 266 other active providers share this practice address in NPPES.
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