NPI age
19 years
Enumerated 2006-07-17
Across 1280 active radiology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00828066A | |
| 01 (GA) | P00913763 | RR MEDICARE |
| 01 (GA) | 038407 | STATE LICENSE |
Part of a multi-provider practice. 60 other active providers share this practice address in NPPES.
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