NPI age
19 years
Enumerated 2006-09-02
Across 2726 active pediatrics providers in Georgia.
6 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 2928517070C | |
| 01 (GA) | 424208 | WELLCARE |
| 01 (GA) | 01191774 | AMERIGROUP |
| 05 (GA) | 2928517070B | |
| 01 (GA) | 582117020024 | TRICARE |
| 01 (GA) | 424145 | WELLCARE |
| 01 (GA) | 582117020030 | TRICARE |
| 05 (GA) | 2928517070D | |
| 01 (GA) | 52703777 | BCBS |
| 01 (GA) | 530652 | WELLCARE |
| 01 (GA) | 582117020 | TRICARE |
| 05 (GA) | 2928517070F | |
| 01 (GA) | 454241 | WELLCARE |
| 01 (GA) | 4858323 | CIGNA |
| 01 (GA) | 582117020018 | TRICARE |
| 01 (GA) | 7955625 | AETNA |
| 05 (GA) | 2928517070E | |
| 01 (GA) | 454249 | WELLCARE |
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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