NPI age
19 years
Enumerated 2007-01-02
Across 539 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 044433 | STATE LIC |
| 05 (GA) | 00763221A |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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