NPI age
19 years
Enumerated 2007-03-21
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | GA 040900 | GA MEDICAL LICENSE |
| 01 (FL) | OS 6892 | FL LICENSE |
| 05 (GA) | 00737338B |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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