NPI age
20 years
Enumerated 2005-11-22
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 062147 | BLUE CROSS |
| 01 | 003116112A | MEDICAID PAYEE ID |
| 05 (GA) | 000405402D | |
| 01 | 110124115 | RAILROAD MEDICARE |
Part of a multi-provider practice. 15 other active providers share this practice address in NPPES.
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