Healthcare Provider Details

I. General information

NPI: 1205752466
Provider Name (Legal Business Name): WHOLE HEALTH PEDIATRICS OF GEORGIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10180 DALLAS ACWORTH HWY SUITE 101
DALLAS GA
30132
US

IV. Provider business mailing address

10180 DALLAS ACWORTH HWY SUITE 101
DALLAS GA
30132
US

V. Phone/Fax

Practice location:
  • Phone: 678-472-9500
  • Fax:
Mailing address:
  • Phone: 678-472-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KADIAN K MAGERL
Title or Position: FOUNDER & CLINICAL DIRECTOR
Credential: DNP, CPNP-PC
Phone: 678-820-1172