NPI age
19 years
Enumerated 2007-05-18
Across 66 active obstetrics & gynecology providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (NC) | 2009-00522 | NORTH CAROLINA MEDICAL BOARD |
| 01 (AL) | MD.27968 | ALABAMA MEDICAL LICENSE |
| 01 (GA) | 067770 | GEORGIA COMPOSITE MEDICAL BOARD |
| 05 (AL) | 155775 | |
| 05 (GA) | 003124336 | |
| 01 (GA) | 202I160975 | MEDICARE PTAN |
Part of a multi-provider practice. 36 other active providers share this practice address in NPPES.
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