NPI age
13 years
Enumerated 2012-06-06
Across 5027 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 82449 | GA PROVIDER LICENSE- DO |
Part of a multi-provider practice. 20 other active providers share this practice address in NPPES.
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