NPI age
19 years
Enumerated 2006-12-01
Across 414 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (MI) | 450327810 | |
| 01 | JV053567 | CHAMPUS-CHAMPUS |
| 01 | JV053567 | COMMERCIAL-COMMERCIAL NUMBER |
| 05 (GA) | 003141369A | |
| 01 | 440Q263940 | BLUE CROSS-BLUE CROSS |
| 01 (GA) | 52609049 001 | BCBS OF GEORGIA |
Part of a multi-provider practice. 87 other active providers share this practice address in NPPES.
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