NPI age
20 years
Enumerated 2005-09-14
Across 5027 active internal medicine providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (OH) | 2031607 | |
| 01 (GA) | 11SCGCS | MEDICARE PTAN |
| 05 (GA) | 694476929A |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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