MEDICARE: DR. ANA MARIA PIMENTEL M.D.

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	33920	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225104490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANA MARIA PIMENTEL M.D.

Provider Business Mailing Address
First Line	:	4469 BRIARCLIFF RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-2148
Country	:	US
Telephone Number	:	770-414-0758
Fax Number	:	770-414-5042

Provider Business Practice Location Address
First Line	:	2695 BUFORD HWY NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-3278
Country	:	US
Telephone Number	:	404-616-6999
Fax Number	:	404-616-0020

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

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	07/08/2007

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