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NPI Code Detail

MEDICARE: ATLANTA CHILD NEUROLOGY, PC

MEDICARE: ATLANTA CHILD NEUROLOGY, PC
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
12080P0008XPediatric Neurodevelopmental Disabilities Physician

General Provider Information

NPI Number : 1356527329
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATLANTA CHILD NEUROLOGY, PC
Provider Business Mailing Address
First Line : 975 JOHNSON FERRY RD NE STE 360
Second Line :
City : ATLANTA
State : GA
Zip : 30342-4735
Country : US
Telephone Number : 404-255-2670
Fax Number :
Provider Business Practice Location Address
First Line : 975 JOHNSON FERRY RD NE STE 360
Second Line :
City : ATLANTA
State : GA
Zip : 30342-4735
Country : US
Telephone Number : 404-255-2670
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : GERALD M SILVERBOARD
Credential : MD
Telephone Number : 404-255-2670
Provider Enumeration Date : 01/21/2008
Last Update Date : 01/21/2008

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Directions to “ATLANTA CHILD NEUROLOGY, PC ” Practice Location

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