NPI age
20 years
Enumerated 2006-03-14
Across 52 active pediatrics providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 | 2134940 | AETNA HMO POS |
| 01 | 5433953006 | CIGNA |
| 01 | REF000087396 | MEDICAID REFERENCE PROVID |
| 01 | 000709497H | MEDICAID PROVIDER NUMBER |
| 01 | 52508068010 | BLUE CHOICE PROVIDER ID |
| 05 (GA) | 000981901A | |
| 01 | 5757428 | AETNA MC PPO PIN NUMBER |
| 01 | 1422312 | UNITED HEALTH CARE |
| 01 | 080685 | BLUE CHOICE FAC INSURANCE |
| 01 | 1789 | KAISER |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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