NPI age
19 years
Enumerated 2006-09-27
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (MT) | 0024191 | |
| 05 (WY) | 1193597 | |
| 01 (MT) | 13771 | BLUE CROSS |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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