NPI age
19 years
Enumerated 2006-06-13
Across 238 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (PA) | 101672879 | |
| 01 (PA) | 50065666 | CAPITAL BLUE CROSS |
| 01 (PA) | P00418739 | RAILROAD MEDICARE PIN |
| 01 (PA) | 1877187 | HIGHMARK BLUE SHIELD |
Part of a multi-provider practice. 439 other active providers share this practice address in NPPES.
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