NPI age
17 years
Enumerated 2008-07-14
Across 5448 active family medicine providers in Georgia.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 163454222C | |
| 01 | 511G700847 | MEDICARE PTAN |
Multi-provider organization. 1 individual provider on file at this primary address.
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