NPI age
20 years
Enumerated 2005-08-24
Across 539 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000401178E | |
| 05 (GA) | 300028737A | |
| 01 (GA) | 592806 | BCBS OF GEORGIA |
| 05 (GA) | 000401178D |
Solo or small practice. No other active providers share this practice address in NPPES.
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