NPI age
19 years
Enumerated 2006-06-27
Across 85 active emergency medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (MD) | 61400002 | BLUECROSS PROVIDER NUMBER |
| 01 (GA) | 70155 | MEDICAL LICENSE |
| 01 (FL) | ME 107308 | MEDICAL LICENSE |
Part of a multi-provider practice. 21 other active providers share this practice address in NPPES.
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