| NPI | 1720285653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY COOK WALTER Director System Credentialing 404-778-2144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP3000X Anesthesiology, Pediatric Anesthesiology |
| Additional Taxonomies | 207NP0225X Dermatology, Pediatric Dermatology |
| 207XP3100X Orthopaedic Surgery, Pediatric Orthopaedic Surgery | |
| 207YP0228X Otolaryngology, Pediatric Otolaryngology | |
| 207ZP0213X Pathology, Pediatric Pathology | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 2085P0229X Radiology, Pediatric Radiology | |
| 2086S0120X Surgery, Pediatric Surgery | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-08-22 |