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General NPI Number Information
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NPI Number | 1437355062
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Entity Type | Organization
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Legal Business Name | MATERNAL MEDICINE CTR
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 05/10/2012
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Provider Practice Location Address
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Address Line | 1630 PEACHTREE INDUSTRIAL BLVD STE A
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City | SUWANEE
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State | GA
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Zip | 30024-1839
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Country | US
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Telephone | 770-831-9957
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Fax | 770-831-9958
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Provider Business Mailing Address
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Address Line | 1630 PEACHTREE INDUSTRIAL BLVD STE A
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City | SUWANEE
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State | GA
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Zip | 30024-1839
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Country | US
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Telephone | 770-831-9957
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Fax | 770-831-9958
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Authorized Official
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Title or Position | OWNER
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Name | DR. SYLVIA B LAREMONT
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Credential | M.D.
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Telephone | 770-831-9957
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | GA52113
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License Number State | GA
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