NPI age
12 years
Enumerated 2013-08-27
Across 39 active surgery providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (SC) | 22N33N45 | CONTROLLED SUBSTANCES NUMBER |
| 01 (SC) | 2536086 | STATE REGISTRATION NUMBER |
Part of a multi-provider practice. 38 other active providers share this practice address in NPPES.
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