NPI age
7 years
Enumerated 2019-05-11
Across 89 active pediatrics providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 104540 | GEORGIA MEDICAL LICENSE |
Part of a multi-provider practice. 185 other active providers share this practice address in NPPES.
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