NPI age
20 years
Enumerated 2005-11-16
Across 18 active pediatrics providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | N39665 | |
| 05 (GA) | 813658737A | |
| 05 (NC) | 8969208 |
Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.
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