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General NPI Number Information
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NPI Number | 1508975624
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Entity Type | Organization
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Legal Business Name | CHILDREN'S MEDICINE, P.C.
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3685 LAWRENCEVILLE HWY SUITE 100
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-4107
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Country | US
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Telephone | 770-921-7386
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Fax | 770-381-6013
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Provider Business Mailing Address
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Address Line | 3685 LAWRENCEVILLE HWY SUITE 100
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-4107
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Country | US
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Telephone | 770-921-7386
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Fax | 770-381-6013
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | TRUDY HUNLEY
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Credential |
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Telephone | 770-921-7386
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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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