NPI age
19 years
Enumerated 2006-10-13
Across 494 active internal medicine providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (AR) | 152732001 | |
| 01 (AR) | P00075978 | RAILROAD MEDICARE1 |
| 01 (AR) | 5M296 | BCBS |
| 05 (TN) | 1509226 | |
| 01 (AR) | 03120018000 | QUALCHOICE |
Part of a multi-provider practice. 9 other active providers share this practice address in NPPES.
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