NPI age
16 years
Enumerated 2010-04-30
Across 5027 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (SC) | SCH508K108 | MEDICARE |
| 05 (FL) | 022139100 | |
| 01 (FL) | JC391Z | MEDICARE |
Part of a multi-provider practice. 38 other active providers share this practice address in NPPES.
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