NPI age
19 years
Enumerated 2007-04-23
Across 562 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (AR) | 5CC99 | BCBS |
| 01 (AL) | 51007084 | BCBS |
| 05 (AL) | 009913548 | |
| 05 (AR) | 206432001 |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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