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General NPI Number Information
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NPI Number | 1568546380
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Entity Type | Organization
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Legal Business Name | GASTROENTEROLOGY CONSULTANTS,PC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 03/04/2020
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Provider Practice Location Address
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Address Line | 11685 ALPHARETTA HWY STE 320
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City | ROSWELL
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State | GA
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Zip | 30076-4910
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Country | US
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Telephone | 770-442-5882
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Fax | 770-754-9749
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Provider Business Mailing Address
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Address Line | 11685 ALPHARETTA HWY STE 320
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City | ROSWELL
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State | GA
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Zip | 30076-4910
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Country | US
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Telephone | 770-442-5882
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Fax | 770-754-9749
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. MEREDITH THOMAS RIDDICK
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Credential | M.D.
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Telephone | 770-442-5882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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