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General NPI Number Information
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NPI Number | 1851494447
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Entity Type | Organization
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Legal Business Name | CRESCENT PEDIATRICS
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 02/01/2011
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Provider Practice Location Address
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Address Line | 2925 PREMIERE PKWY SUITE 140
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City | DULUTH
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State | GA
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Zip | 30097
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Country | US
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Telephone | 770-495-6222
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Fax | 770-495-9959
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Provider Business Mailing Address
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Address Line | 2925 PREMIERE PKWY SUITE 140
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City | DULUTH
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State | GA
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Zip | 30097
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Country | US
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Telephone | 770-495-6222
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Fax | 770-495-9959
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM MONEIT
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Credential | MD
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Telephone | 770-495-6222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 034204
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 034204
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License Number State | GA
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