NPI age
19 years
Enumerated 2006-10-18
Across 1389 active surgery providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 061183 | MEDICAL LICENSE |
| 05 (GA) | 119298176C |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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