NPI age
19 years
Enumerated 2006-06-08
Across 4616 active physician assistant providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (SC) | QM0627 | |
| 01 (SC) | P00103539 | RR MEDICARE |
| 01 (SC) | 576007863100 | BCBS OF SC |
Part of a multi-provider practice. 20 other active providers share this practice address in NPPES.
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