NPI age
20 years
Enumerated 2005-07-07
Across 1881 active specialist providers in Georgia.
4 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000018092A | |
| 01 (GA) | 52241377 | BLUE CROSS BLUE SHIELD |
Multi-provider organization. 4 individual providers on file at this primary address.
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