NPI age
20 years
Enumerated 2006-04-04
Across 483 active pathology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 028340 | GA MEDICAL LICENSE# |
| 05 (GA) | 000335695A | |
| 01 | 22CDBCS | MEDICARE GROUP NUMBER |
| 01 (AL) | 00004562 | AL MEDICAL LICENSE# |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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