NPI age
19 years
Enumerated 2006-07-26
Across 952 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (NY) | 193652 | NY LICENSE |
| 05 (GA) | 000788796A | |
| 01 (GA) | 1760576656 | GROUP NPI |
| 01 (GA) | 045562 | GA LICENSE |
| 01 (GA) | 110166903 | RAIL ROAD MEDICARE |
Part of a multi-provider practice. 12 other active providers share this practice address in NPPES.
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