NPI age
19 years
Enumerated 2006-09-13
Across 115 active pediatrics providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (MO) | 201961901 | |
| 05 (GA) | 700216987A |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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