NPI age
19 years
Enumerated 2006-06-03
Across 220 active radiology providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 046566 | GEORGIA LICENSE |
| 05 (GA) | 00808904A |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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