NPI age
20 years
Enumerated 2005-08-18
Across 5027 active internal medicine providers in Georgia.
3 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | 905606 | SOUTHCARE |
| 01 (GA) | 52237698001 | BLUE CROSS/BLUE SHIELD |
| 05 (GA) | 00349027A |
Multi-provider organization. 3 individual providers on file at this primary address.
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