NPI age
19 years
Enumerated 2007-01-21
Across 1678 active psychiatry & neurology providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003104047G | |
| 01 (GA) | P01366679 | RR MEDICARE |
| 01 (GA) | 02036288 | AMERIGROUP |
| 01 (GA) | 983434 | WELLCARE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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