NPI age
18 years
Enumerated 2007-12-20
Across 105 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 616446282F | |
| 05 (GA) | 616446282V |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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