| NPI | 1871689265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAUNCEY DANIELS CEO 404-765-9437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: GA 027494) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-09-16 |