NPI age
20 years
Enumerated 2005-07-15
Across 25 active orthopaedic surgery providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000675672F | |
| 01 (GA) | 20BBDBC | MEDICARE ID ASSOCIATED WITH INDIVIDUAL NPI 1992704514 |
| 01 (GA) | 709295 | BCBS |
| 01 (GA) | 300015788E | MEDICAID PAYOR NUMBER |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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