Healthcare Provider Details

I. General information

NPI: 1831289842
Provider Name (Legal Business Name): CORNERSTONE PEDIATRICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8601 BALDWIN PKWY SUITES 2A & 2B
DOUGLASVILLE GA
30134-5625
US

IV. Provider business mailing address

8601 BALDWIN PKWY SUITES 2A & 2B
DOUGLASVILLE GA
30134-5625
US

V. Phone/Fax

Practice location:
  • Phone: 678-838-0552
  • Fax: 678-838-0929
Mailing address:
  • Phone: 678-838-0552
  • Fax: 678-838-0929

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. CHERYL CLIFF
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 678-838-0552