NPI age
19 years
Enumerated 2006-07-28
Across 494 active internal medicine providers in Georgia.
4 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 015953 | MEDICAL LICENSE |
| 05 (SC) | 150605 | |
| 05 (GA) | 000040532G | |
| 05 (GA) | 000040532A | |
| 05 (GA) | 000040532E |
Part of a multi-provider practice. 538 other active providers share this practice address in NPPES.
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