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General NPI Number Information
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NPI Number | 1699942201
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Entity Type | Individual
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Provider Name | FREDLY EMANUEL BATAILLE MD
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Gender | Male
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 490 BILL KENNEDY WAY SE SUITE 101
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City | ATLANTA
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State | GA
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Zip | 30316-6835
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Country | US
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Telephone | 404-446-4726
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Fax | 404-446-4727
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Provider Business Mailing Address
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Address Line | 3133 SILVER HILL TER SE
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City | ATLANTA
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State | GA
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Zip | 30316-6710
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Country | US
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Telephone | 404-242-2751
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2579
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License Number State | GA
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