NPI age
20 years
Enumerated 2006-01-23
Across 2726 active pediatrics providers in Georgia.
6 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 302587 | WELLCARE |
| 01 (GA) | 52684584 | BCBS |
| 01 (GA) | 5402578 | AETNA PPO |
| 01 (GA) | 8238671 | CIGNA |
| 05 (GA) | 000754157M | |
| 05 (GA) | 000754157P | |
| 05 (GA) | 000754157Q | |
| 01 (GA) | 1939869 | UNITED HEALTHCARE |
| 01 (GA) | 302571 | WELLCARE |
| 05 (GA) | 000754157N | |
| 05 (GA) | 000754157R | |
| 01 (GA) | 10032982 | AMERIGROUP |
| 01 (GA) | 302567 | WELLCARE |
| 01 (GA) | 2276934 | AETNA HMO |
| 01 (GA) | 302588 | WELLCARE |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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