| NPI | 1346606076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUETTA CODY Mgr, Provider Enrollment 404-785-7876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 122300000X Dentist |
| 207PP0204X Emergency Medicine Pediatric Emergency Medicine | |
| 207SG0201X Medical Genetics Clinical Genetics (M.D.) | |
| 207ZP0213X Pathology Pediatric Pathology | |
| 2080C0008X Pediatrics Child Abuse Pediatrics | |
| 2080P0207X Pediatrics Pediatric Hematology-Oncology | |
| 2081P0010X Physical Medicine & Rehabilitation Pediatric Rehabilitation Medicine | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| 208M00000X Hospitalist | |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2023-02-23 |