NPI age
20 years
Enumerated 2006-03-08
Across 5448 active family medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 840736398A | |
| 01 (GA) | 055984 | MEDICAL LICENSE |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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