NPI age
20 years
Enumerated 2005-09-19
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000376087A | |
| 01 (GA) | 31013 | STATE OF GA |
| 01 | 498108 | BCBS |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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