NPI age
19 years
Enumerated 2007-05-03
Across 5027 active internal medicine providers in Georgia.
9 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 045117 | GEORGIA MEDICAL LICENSE |
| 01 (GA) | 52746974 | BCBS OF GA |
| 05 (GA) | 00823347B |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 9 individual providers on file at this primary address.
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