NPI age
19 years
Enumerated 2006-06-23
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000866742C | |
| 01 (GA) | 197971 | BLUE SHIELD OF GA |
Part of a multi-provider practice. 169 other active providers share this practice address in NPPES.
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