NPI age
20 years
Enumerated 2006-04-12
Across 562 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 663552717K | |
| 05 (GA) | 663552717M | |
| 05 (GA) | 663552717J | |
| 05 (GA) | 663552717R | |
| 05 (GA) | 663552717P | |
| 01 (GA) | 055128 | GA STATE LICENSE |
| 05 (GA) | 663552717Q | |
| 05 (GA) | 663552717L |
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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