NPI age
17 years
Enumerated 2008-07-14
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | DH1281 | RAILROAD MEDICARE - GROUP # |
| 01 (GA) | 498159 | WELLCARE |
| 01 (GA) | 205778734007 | TRICARE SOUTH REGION |
| 05 (GA) | 871249394A | |
| 01 (GA) | 61310 | PHYSICIAN LICENSE # |
| 01 (GA) | P00787894 | RAILROAD MEDICARE - PTAN |
| 01 (GA) | 11D1098856 | CLIA ID |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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