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General NPI Number Information
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NPI Number | 1356456214
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Entity Type | Organization
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Legal Business Name | GROWING UP PEDIATRICS, P.C.
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 200 RIVERHILLS BUSINESS PARK SUITE 250
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City | BIRMINGHAM
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State | AL
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Zip | 35242-8112
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Country | US
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Telephone | 205-995-0899
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Fax | 205-995-0451
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Provider Business Mailing Address
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Address Line | 200 RIVERHILLS BUSINESS PARK SUITE 250
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City | BIRMINGHAM
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State | AL
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Zip | 35242-8112
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Country | US
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Telephone | 205-995-0899
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Fax | 205-995-0451
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Authorized Official
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Title or Position | ADMINISTRATOR/TREASURER
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Name | JEFF BONNER
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Credential |
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Telephone | 205-995-0899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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