| NPI | 1619155306 |
|---|---|
| Doing Business As | MAIN STREET PEDIATRICS PC |
| Entity Type | Organization |
| Authorized Contact | MARIBEL LABINDALAWA ANGKA SERVERA Physician 678-205-2437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 047388) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 047657) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2009-01-22 |