NPI age
20 years
Enumerated 2006-01-10
Across 450 active otolaryngology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (ME) | 001057 | ANTHEM |
| 05 (GA) | 003228353A | |
| 05 (ME) | 121840000 |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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