NPI age
19 years
Enumerated 2007-05-17
Across 5448 active family medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 | 0101932 | UNITED HEALTHCARE |
| 05 (GA) | 00253096H | |
| 01 (GA) | 202I086627 | MEDICARE PTAN |
| 01 (GA) | 257879 | BLUE CROSS & BLUE SHIELD |
| 01 | A002 | TRICARE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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