NPI age
20 years
Enumerated 2006-05-06
Across 1991 active emergency medicine providers in Georgia.
3 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (AZ) | 25321 | ARIZONA MEDICAL LICENSE |
| 05 (SC) | G47251 | |
| 01 (TX) | U6648 | TEXAS MEDICAL LICENSE |
| 05 (SC) | 000823292H |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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