NPI age
18 years
Enumerated 2007-11-21
Across 1881 active specialist providers in Georgia.
2 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000270905A | |
| 01 (GA) | D30479 | UPIN |
| 01 (GA) | $$$$$$$$$ | SOCIAL SECURITY NUMBER |
| 01 (GA) | 010001168 | RAILROAD MEDICARE |
Multi-provider organization. 2 individual providers on file at this primary address.
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