NPI age
19 years
Enumerated 2006-12-19
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 215105 | BLUE CROSS BLUE SHIELD |
| 01 (GA) | 5820010480000E | FED I.D. |
| 01 (GA) | 582001048 | TAX I.D. |
Part of a multi-provider practice. 133 other active providers share this practice address in NPPES.
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