NPI age
19 years
Enumerated 2006-11-01
Across 1893 active obstetrics & gynecology providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 937878 | BC/BS |
| 01 (GA) | 11D0909097 | CLIA ID |
| 01 (GA) | 341177 | WELLCARE |
| 01 (GA) | 036135 | PHYSICIAN LICENSE |
| 05 (GA) | 000669347C | |
| 01 (GA) | DH1281 | RAILROAD MEDICARE - GROUP # |
| 01 (GA) | P00473719 | RAILROAD MEDICARE - PTAN |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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