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General NPI Number Information
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NPI Number | 1629374418
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Entity Type | Organization
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Legal Business Name | ATLANTA WEST WOMEN'S CENTER
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 4904 TIMBER RIDGE DR SUITE 303
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-1828
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Country | US
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Telephone | 770-920-9745
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Fax | 770-920-9760
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Provider Business Mailing Address
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Address Line | 4904 TIMBER RIDGE DR SUITE 303
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-1828
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Country | US
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Telephone | 770-920-9745
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Fax | 770-920-9760
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASWANT S CHADDHA
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Credential | MD
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Telephone | 770-920-9745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 35023
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License Number State | GA
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