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PEDIATRIC GASTROENTEROLOGY ASSOCIATES NPI 1801903232


NPI Information

NPI: 1801903232
Provider Name: PEDIATRIC GASTROENTEROLOGY ASSOCIATES
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
465 WINN WAY
SUITE 215
DECATUR, GA
ZIP 30030
Phone: (404) 508-5315
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PEDIATRIC GASTROENTEROLOGY ASSOCIATES is a specialist in Decatur, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PEDIATRIC GASTROENTEROLOGY ASSOCIATES NPI is 1801903232. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

465 WINN WAY
SUITE 215
DECATUR, GA
ZIP 30030-753
Phone: (404) 508-5315
Fax: (404) 508-5313

The provider's authorized official is Walter Ifeadike .
The authorized official title is Physician/ Owner and has the following contact phone number (404) 508-5315.

The enumeration date for this NPI number is 8/23/2006 and was last updated on 8/22/2020.


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
1174400000XSpecialist0385519GEORGIAYes

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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