NPI age
20 years
Enumerated 2005-08-10
Across 397 active podiatrist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 202I489461 | MEDICARE PTAN |
| 05 (GA) | 000494491D |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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