MEDICARE: DR. VINCENT JOHN CENDAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	111666	GA
2	207R00000X	Internal Medicine Physician	111666	GA
3	2080P0207X	Pediatric Hematology & Oncology Physician	111666	GA
4	207RH0000X	Hematology (Internal Medicine) Physician	111666	GA

General Provider Information

NPI Number	:	1073267837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT JOHN CENDAN MD

Provider Business Mailing Address
First Line	:	100 WOODRUFF CIR NE
Second Line	:	ATTN: PEDIATRIC HEMATOLOGY/ONCOLOGY
City	:	ATLANTA
State	:	GA
Zip	:	30322-1020
Country	:	US
Telephone Number	:	404-778-4834
Fax Number	:	404-727-4455

Provider Business Practice Location Address
First Line	:	100 WOODRUFF CIR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1020
Country	:	US
Telephone Number	:	404-778-4834
Fax Number	:	404-727-4455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2022
Last Update Date	:	06/10/2026

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