NPI age
17 years
Enumerated 2008-10-02
Across 952 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 01720105 | AMERIGROUP |
| 01 (GA) | P01142578 | RR MEDICARE |
| 01 (GA) | 722915 | WELLCARE |
| 05 (GA) | 003128905A |
Part of a multi-provider practice. 47 other active providers share this practice address in NPPES.
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