NPI age
14 years
Enumerated 2011-06-06
Across 562 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (UT) | 7960601-1205 | PHYSICIAN AND SURGEON |
| 01 (UT) | 7960601-8905 | PHYSICIAN/SURGEON CS SCHEDULE 2-5 |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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