NORTHSIDE MATERNIDAD NPI 1477912475

NPI Information

NPI: 1477912475
Provider Name: NORTHSIDE MATERNIDAD
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
5395 JIMMY CARTER BLVD
SUITE 500
NORCROSS, GA
ZIP 30093
Phone: (678) 585-4787
Get Directions

NORTHSIDE MATERNIDAD is a medical specialty clinic center in Norcross, GA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). NORTHSIDE MATERNIDAD NPI is 1477912475. The provider is registered as an organization entity type.

The provider's business location address is:

5395 JIMMY CARTER BLVD
SUITE 500
NORCROSS, GA
ZIP 30093-502
Phone: (678) 585-4787
Fax: (470) 375-8759

The provider's authorized official is Neale P. Freeman .
The authorized official title is Owner and has the following contact phone number (678) 585-4787.

The enumeration date for this NPI number is 2/18/2016 and was last updated on 2/18/2016.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM2500X	Clinic/Center	Medical Specialty	040065	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	003169207A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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