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PEDIATRICS AND ADULT MEDICINE INC. NPI 1598125312


NPI Information

NPI: 1598125312
Provider Name: PEDIATRICS AND ADULT MEDICINE INC.
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 11D2134583

Address:
4153 FLAT SHOALS PKWY BLD C
SUITE 300B
DECATUR, GA
ZIP 30034
Phone: (404) 386-6510
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PEDIATRICS AND ADULT MEDICINE INC. is a primary care clinic center in Decatur, GA. PEDIATRICS AND ADULT MEDICINE INC. NPI is 1598125312. The provider is registered as an organization entity type.

The provider's business location address is:

4153 FLAT SHOALS PKWY BLD C
SUITE 300B
DECATUR, GA
ZIP 30034-106
Phone: (404) 386-6510
Fax: (404) 500-2097

The provider's authorized official is Michele Sewell .
The authorized official title is Owner and has the following contact phone number (770) 639-7993.

The CLIA number assigned to this NPI record is 11D2134583 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/7/2016 and was last updated on 3/3/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QP2300XClinic/CenterPrimary CareYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHERGEORGIAIRS INDIVIDUAL TAXPAYER IDENTIFICATION NUMBER

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: 4/28/2024

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