NPI age
19 years
Enumerated 2006-07-07
Across 39 active surgery providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 349724 | WELLCARE |
| 05 (SC) | G51626 | |
| 01 (GA) | 10063478 | AMERIGROUP |
| 05 (GA) | 000968261A | |
| 01 (GA) | 020052888 | RR MEDICARE |
Part of a multi-provider practice. 71 other active providers share this practice address in NPPES.
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