NPI age
18 years
Enumerated 2007-06-29
Across 1389 active surgery providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003134994B | |
| 01 (GA) | 65089 | GEORGIA |
| 05 (GA) | 003134994A | |
| 01 (GA) | 58 1719867 047 | BCBS |
| 01 (AL) | 602-03641 | BCBS |
Part of a multi-provider practice. 12 other active providers share this practice address in NPPES.
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