NPI age
19 years
Enumerated 2007-01-16
Across 661 active general practice providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 505611224A | |
| 01 (GA) | 10040657 | AMERIGROUP |
| 05 (GA) | 505611224B |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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