NPI age
19 years
Enumerated 2006-11-24
Across 58 active clinic/center providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 52598825 | BC-BS PROVIDER NUMBER |
| 01 (GA) | P00063679 | MEDICARE RAILROAD |
Single-site organization. Only one practice location on file.
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