NPI age
20 years
Enumerated 2006-01-16
Across 127 active surgery providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | 376444 | |
| 01 (SC) | SC5157E499 | MEDICARE PTAN |
| 01 (SC) | P01512717 | RAILROAD MEDICARE |
| 05 (GA) | 202I248316 |
Part of a multi-provider practice. 12 other active providers share this practice address in NPPES.
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