NPI age
19 years
Enumerated 2006-06-08
Across 1280 active radiology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 036373 | STATE LICENSE # |
| 05 (GA) | 00544794C |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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