NPI age
19 years
Enumerated 2006-12-11
Across 1678 active psychiatry & neurology providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 | OO074832 | CHAMPUS-CHAMPUS |
| 01 | 7509104450 | BLUE CROSS-BLUE CROSS |
| 05 (GA) | 974647115F | |
| 01 | OO074832 | COMMERCIAL-COMMERCIAL NUMBER |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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