NPI age
19 years
Enumerated 2007-04-27
Across 4616 active physician assistant providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003108143A | |
| 01 (GA) | 202I976846 | MEDICARE PTAN |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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