NPI age
14 years
Enumerated 2011-07-08
Across 640 active physician assistant providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 4410630001 | DMERC PALMETTO |
| 05 (GA) | 003116570A | |
| 01 (GA) | 202I971136 | MEDICARE PTAN |
Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.
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