PEDIA DOC CHILDREN'S MED CTR NPI 1518110451

NPI Information

PEDIA DOC CHILDREN'S MED CTR is an adolescent medicine pediatrics in Atlanta, GA. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. PEDIA DOC CHILDREN'S MED CTR NPI is 1518110451. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3088 CAMPBELLTON RD SW
ATLANTA, GA
ZIP 30311-410
Phone: (404) 344-2828
Fax: (404) 344-8384

The provider's authorized official is Rachelle L. Dennis-smith .
The authorized official title is Md and has the following contact phone number (404) 344-2828.

The CLIA number assigned to this NPI record is 11D0897923 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/23/2008 and was last updated on 10/23/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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