NPI age
20 years
Enumerated 2005-06-01
Across 1280 active radiology providers in Georgia.
8 secondary locations on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00784088A | |
| 05 (SC) | G37976 | |
| 01 (GA) | 727278 | BLUE CROSS BLUE SHIELD |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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