NPI age
20 years
Enumerated 2006-01-04
Across 643 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000623059F | |
| 01 (GA) | 11BDSLT | MEDICARE PTAN |
Part of a multi-provider practice. 22 other active providers share this practice address in NPPES.
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