Provider Demographics
NPI:1316944671
Name:MONEIT, WILLIAM
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:MONEIT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 PREMIERE PKWY
Mailing Address - Street 2:SUITE #140
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097
Mailing Address - Country:US
Mailing Address - Phone:770-495-6222
Mailing Address - Fax:770-495-9959
Practice Address - Street 1:2925 PREMIERE PKWY
Practice Address - Street 2:SUITE #140
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097
Practice Address - Country:US
Practice Address - Phone:770-495-6222
Practice Address - Fax:770-495-9959
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA034204208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000449611CMedicaid