NPI age
18 years
Enumerated 2007-06-11
Across 29 active dermatology providers in Georgia.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 050931 | LICENSE |
| 01 | 1194717447 | NPI INDIVIDUAL |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 1 individual provider on file at this primary address.
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