NPI age
19 years
Enumerated 2007-05-21
Across 115 active pediatrics providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (AL) | 111017 | |
| 01 (AL) | 515-99848 | BCBS |
| 01 (AL) | 515-98367 | BCBS |
| 05 (AL) | 110478 | |
| 01 (AL) | 1538377502 | TRICARE SOUTH |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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