NPI age
20 years
Enumerated 2006-04-10
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 720172314B | |
| 01 (GA) | 867920 | BCBS PROVIDER NUMBER |
| 05 (GA) | 720172314A |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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