NPI age
15 years
Enumerated 2010-07-08
Across 4616 active physician assistant providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (CO) | PA.0004937 | MEDICAL LICENSE |
| 05 (CO) | 9000158036 |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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