NPI age
17 years
Enumerated 2008-07-11
Across 952 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (MI) | 1609030394 | |
| 01 | 12330056 | CAQH |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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