NPI age
19 years
Enumerated 2007-05-03
Across 292 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (OH) | 2969677 | |
| 01 (NC) | 17627 | BCBS NC |
| 01 (GA) | GRP4720 | GRP # |
| 01 (NC) | P01420250 | RR MEDICARE |
| 05 (GA) | 003175900A |
Part of a multi-provider practice. 29 other active providers share this practice address in NPPES.
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