NPI age
19 years
Enumerated 2007-04-06
Across 78 active orthopaedic surgery providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (VA) | 0101241963 | STATE MEDICAL LICENSE |
| 01 (NC) | 2007-01172 | STATE MEDICAL LICENSE |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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