NPI age
19 years
Enumerated 2007-04-25
Across 127 active surgery providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 64156 | MEDICAL LICENSE |
| 01 (CA) | G87530 | MEDICAL LICENSE |
Part of a multi-provider practice. 38 other active providers share this practice address in NPPES.
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