NPI age
20 years
Enumerated 2006-02-08
Across 1333 active physician assistant providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 10448572 | NCCPA |
| 05 (GA) | 360301582A | |
| 01 (GA) | 003559 | STATE LICENSE |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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