NPI age
20 years
Enumerated 2006-04-13
Across 1893 active obstetrics & gynecology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (PA) | 0019726940005 | |
| 05 (PA) | 0019726940001 | |
| 05 (GA) | 653434213B | |
| 01 (PA) | 1523078 | BLUE SHIELD |
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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