NPI age
19 years
Enumerated 2007-05-22
Across 952 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (LA) | 1033537 | |
| 05 (MS) | 02780071 | |
| 01 (GA) | CS1712105106 | CARESOURCE |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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