NPI age
19 years
Enumerated 2006-12-05
Across 643 active internal medicine providers in Georgia.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 300029134A | |
| 01 (GA) | CA5040 | RAILROAD MEDICARE |
| 01 (GA) | 1023084000 | BCBS |
| 01 (GA) | 11D090618 | CLIA |
Multi-provider organization. 1 individual provider on file at this primary address.
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