NPI age
19 years
Enumerated 2007-03-14
Across 952 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 0239087 | BLUE CROSS BLUE SHIELD |
| 01 (GA) | 340262 | WELLCARE (MEDICAID) |
| 05 (GA) | 00381587A | |
| 01 (GA) | 10041326 | AMERIGROUP (MEDICAID) |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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