NPI age
20 years
Enumerated 2005-11-30
Across 952 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 | 1821072398 | NPI |
| 05 (GA) | 000360808G | |
| 01 (GA) | 926016 | POCG |
| 01 (GA) | 37046 | MEDICAL LICENSE |
| 05 (GA) | REF000797672 |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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