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General NPI Number Information
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NPI Number | 1144172545
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Entity Type | Organization
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Legal Business Name | PEDIATRIX MEDICAL GROUP OF GEORGIA, P.C.
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Dates
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Enumeration Date | 02/10/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 677 CHURCH ST NE
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City | MARIETTA
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State | GA
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Zip | 30060-1101
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Country | US
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Telephone | 770-793-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 CONCORD TER
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City | SUNRISE
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State | FL
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Zip | 33323-2843
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Country | US
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Telephone | 800-243-3839
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Fax |
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Authorized Official
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Title or Position | ASSISTANT SECRETARY
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Name | NICHOLAS E GLASER
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Credential |
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Telephone | 800-243-3839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number |
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License Number State |
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