NPI age
18 years
Enumerated 2008-01-31
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003110333 | |
| 01 (GA) | 202I8I2315 | MEDICARE |
| 05 (MN) | ENROLLED |
Part of a multi-provider practice. 70 other active providers share this practice address in NPPES.
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