NPI age
20 years
Enumerated 2006-03-15
Across 1881 active specialist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00465979A | |
| 01 (GA) | 202I028466 | GA MEDICARE |
| 05 (SC) | 120988 | |
| 05 (GA) | 000465979F |
Part of a multi-provider practice. 17 other active providers share this practice address in NPPES.
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