NPI age
20 years
Enumerated 2005-09-07
Across 5027 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (MI) | 70-0-F32947-0 | BCBS CPIN # |
| 01 (MI) | KT014424 | BCBSM |
| 01 (MI) | 1578557559 | NPI # |
| 05 (MI) | 4846727 |
Solo or small practice. No other active providers share this practice address in NPPES.
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