MEDICARE: SEE BABY, LLC

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	207VM0101X	Maternal & Fetal Medicine Physician	041733	GA

General Provider Information

NPI Number	:	1316276769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEE BABY, LLC

Provider Business Mailing Address
First Line	:	550 PEACHTREE ST NE
Second Line	:	SUITE 1165
City	:	ATLANTA
State	:	GA
Zip	:	30308-2208
Country	:	US
Telephone Number	:	678-789-1123
Fax Number	:	404-240-2805

Provider Business Practice Location Address
First Line	:	550 PEACHTREE ST NE
Second Line	:	SUITE 1165
City	:	ATLANTA
State	:	GA
Zip	:	30308-2208
Country	:	US
Telephone Number	:	678-789-1123
Fax Number	:	404-240-2805

Authorized Official
Title or Position	:	DIRECTOR
Name	:	BRADFORD SCOTT BOOTSTAYLOR
Credential	:	MD
Telephone Number	:	678-789-1123

Provider Enumeration Date	:	12/14/2009
Last Update Date	:	12/14/2009

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Directions to “SEE BABY, LLC ” Practice Location

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