Provider Demographics
NPI:1114713187
Name:GREATER ATLANTA INTEGRATIVE PEDIATRICS
Entity type:Organization
Organization Name:GREATER ATLANTA INTEGRATIVE PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAITHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-751-3693
Mailing Address - Street 1:1240 UPPER HEMBREE RD STE A
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-0914
Mailing Address - Country:US
Mailing Address - Phone:404-751-3693
Mailing Address - Fax:470-517-2995
Practice Address - Street 1:1240 UPPER HEMBREE RD STE A
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-0914
Practice Address - Country:US
Practice Address - Phone:404-751-3693
Practice Address - Fax:470-517-2995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty