NPI age
19 years
Enumerated 2006-06-18
Across 77 active pediatrics providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 511379152A | |
| 01 (GA) | 10065021 | AMERIGROUP |
| 01 (GA) | 52172893-002 | BCBS GA |
| 05 (SC) | G56132 | |
| 01 (GA) | 349798 | WELLCARE |
Part of a multi-provider practice. 538 other active providers share this practice address in NPPES.
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