NPI age
20 years
Enumerated 2005-10-24
Across 5027 active internal medicine providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 58914 | MEDICAL LICENSE |
| 01 (MI) | 1235131137 | BCBSM - BLH |
| 05 (MI) | 1992795876 |
Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.
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