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NPI Code Detail

MEDICARE: KIDS DOC PEDIATRICS

MEDICARE: KIDS DOC PEDIATRICS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2300XPrimary Care Clinic/Center043638GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1932374618
Entity Type Code : Organization
Provider Name (Legal Business Name) : KIDS DOC PEDIATRICS
Provider Business Mailing Address
First Line : 3100 FIVE FORKS TRICKUM RD SW STE 204
Second Line :
City : LILBURN
State : GA
Zip : 30047-1887
Country : US
Telephone Number : 770-978-7701
Fax Number : 770-978-7822
Provider Business Practice Location Address
First Line : 3100 FIVE FORKS TRICKUM RD SW STE 204
Second Line :
City : LILBURN
State : GA
Zip : 30047-1887
Country : US
Telephone Number : 770-978-7701
Fax Number : 770-978-7822
Authorized Official
Title or Position : PRESIDENT
Name : AKBER H HASHIM
Credential : M.D.
Telephone Number : 770-978-7701
Provider Enumeration Date : 04/24/2008
Last Update Date : 04/24/2008

Similar Medicare Providers

1588521652 — AMARA RAE LORENZO
Practice Location Address:
3100 FIVE FORKS TRICKUM RD SW STE 203
LILBURN, GA
30047-1887
Practice Phone: 470-485-2220
Practice Fax: 855-803-6288
1609478254 — AJA NIXON
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3100 FIVE FORKS TRICKUM RD SW STE 203
LILBURN, GA
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Practice Fax:
1417222332 — RITA GARCIA CABRERA M.S., BCBA
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3100 FIVE FORKS TRICKUM RD SW STE 203
LILBURN, GA
30047-1887
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Practice Fax: 855-803-6288
1558742882 — RAINBOW STEPS CORPORATION
Practice Location Address:
3100 FIVE FORKS TRICKUM RD SW STE 203
LILBURN, GA
30047-1887
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Practice Fax:
1821552241 — TKEYAH KIANA PIANKHI
Practice Location Address:
3100 FIVE FORKS TRICKUM RD SW STE 203
LILBURN, GA
30047-1887
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Practice Fax:
1548810997 — STONE MOUNTAIN DENTAL 2, PC
Practice Location Address:
3100 FIVE FORKS TRICKUM RD SW STE 402
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Practice Fax: 404-445-8499

Directions to “KIDS DOC PEDIATRICS ” Practice Location

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