NPI age
18 years
Enumerated 2008-04-08
Across 640 active physician assistant providers in Georgia.
6 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 742533948A | |
| 01 (GA) | 587186 | WELLCARE |
| 01 (GA) | 01357356 | AMERIGROUP |
| 05 (GA) | 742533948B |
Part of a multi-provider practice. 33 other active providers share this practice address in NPPES.
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