NPI age
20 years
Enumerated 2005-08-24
Across 539 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 021126 | GEORGIA LICENSE |
| 05 (GA) | 00347608A | |
| 01 (GA) | 52071710 | BCBS GEORGIA |
| 01 (GA) | 581714951 | CHAMPVA COMMERCIAL |
| 01 (GA) | 58171495131061 | CHAMPUSTRICARETRICARLIFE |
Part of a multi-provider practice. 36 other active providers share this practice address in NPPES.
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