| NPI | 1457510158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH J STAATS Office Administrator 770-461-5003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 017642) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2008-06-06 |