Provider Demographics
NPI:1932611068
Name:GREATER ATLANTA PEDIATRICS PC
Entity type:Organization
Organization Name:GREATER ATLANTA PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-322-6161
Mailing Address - Street 1:5674 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-3254
Mailing Address - Country:US
Mailing Address - Phone:770-322-6161
Mailing Address - Fax:
Practice Address - Street 1:5674 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3254
Practice Address - Country:US
Practice Address - Phone:770-322-6161
Practice Address - Fax:770-322-6191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-30
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty