NPI age
20 years
Enumerated 2005-10-26
Across 494 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (KY) | 000000316391 | BLUE CROSS |
| 05 (KY) | 64300288 | |
| 01 | P00113101 | TRAVELERS MEDICARE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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