NPI age
19 years
Enumerated 2006-11-11
Across 115 active pediatrics providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 059459 | GA COMPOSITE BOARD OF MEDICAL EXAMINERS |
| 01 (NC) | 200401529 | NORTH CAROLINA MEDICAL BOARD |
Solo or small practice. No other active providers share this practice address in NPPES.
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