NPI age
19 years
Enumerated 2007-03-02
Across 54 active surgery providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (IL) | 36113869 | ILLINIOS LICENSE |
| 01 (WA) | MD60429831 | PROFESSIONAL LICENSE |
| 01 (MI) | 4301087089 | MICHIGAN LICENSE |
| 01 (PA) | MD425491 | PENNSYLVANIA LICENSE |
Part of a multi-provider practice. 689 other active providers share this practice address in NPPES.
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →