NPI age
19 years
Enumerated 2007-01-24
Across 292 active internal medicine providers in Georgia.
2 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00855181A | |
| 01 | 110201975 | RAILROAD MEDICARE |
| 05 (SC) | TL5840 | |
| 01 | 11D0687551 | GROUP CLIA NUMBER |
Part of a multi-provider practice. 22 other active providers share this practice address in NPPES.
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