Healthcare Provider Details

I. General information

NPI: 1073267837
Provider Name (Legal Business Name): VINCENT JOHN CENDAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WOODRUFF CIR NE
ATLANTA GA
30322-1020
US

IV. Provider business mailing address

100 WOODRUFF CIR NE ATTN: PEDIATRIC HEMATOLOGY/ONCOLOGY
ATLANTA GA
30322-1020
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-4834
  • Fax: 404-727-4455
Mailing address:
  • Phone: 404-778-4834
  • Fax: 404-727-4455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number111666
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number111666
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number111666
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number111666
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: