Healthcare Provider Details

I. General information

NPI: 1922265826
Provider Name (Legal Business Name): PERIMETER PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 02/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 MERCER UNIVERSITY DRIVE STE 100
CHAMBLEE GA
30341-4145
US

IV. Provider business mailing address

3020 MERCER UNIVERSITY DR STE 100
CHAMBLEE GA
30341-4145
US

V. Phone/Fax

Practice location:
  • Phone: 770-458-3383
  • Fax: 770-458-9959
Mailing address:
  • Phone: 770-458-3383
  • Fax: 770-458-9958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS VINCENT ADAMKIEWICZ
Title or Position: DOCTOR/OWNER
Credential: MD
Phone: 770-458-3383