NPI age
20 years
Enumerated 2006-03-21
Across 250 active specialist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 1022740 | ACM PROVIDER |
| 01 (GA) | 52071299001 | BLUE CROSS |
Solo or small practice. No other active providers share this practice address in NPPES.
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