NPI age
19 years
Enumerated 2006-09-27
Across 80 active preventive medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | GA1131 | |
| 05 (GA) | 000280706F | |
| 05 (GA) | 00280706B | |
| 01 (GA) | P00899442 | RAILROAD MEDICARE |
| 05 (GA) | 000280706G |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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