Healthcare Provider Details

I. General information

NPI: 1104251404
Provider Name (Legal Business Name): HB PEDIATRICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2013
Last Update Date: 09/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3957 HOLCOMB BRIDGE RD STE 100
NORCROSS GA
30092-5244
US

IV. Provider business mailing address

3957 HOLCOMB BRIDGE RD STE 100
NORCROSS GA
30092-5244
US

V. Phone/Fax

Practice location:
  • Phone: 770-449-9334
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE KATSITADZE
Title or Position: DOCTER
Credential:
Phone: 770-923-6400