MEDICARE: PERIMETER PEDIATRICS

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	2080P0207X	Pediatric Hematology & Oncology Physician
2	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1922265826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERIMETER PEDIATRICS

Provider Business Mailing Address
First Line	:	3020 MERCER UNIVERSITY DR STE 100
Second Line	:
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-4145
Country	:	US
Telephone Number	:	770-458-3383
Fax Number	:	770-458-9958

Provider Business Practice Location Address
First Line	:	3020 MERCER UNIVERSITY DRIVE
Second Line	:	STE 100
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-4145
Country	:	US
Telephone Number	:	770-458-3383
Fax Number	:	770-458-9959

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	THOMAS VINCENT ADAMKIEWICZ
Credential	:	MD
Telephone Number	:	770-458-3383

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	02/20/2012

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Directions to “PERIMETER PEDIATRICS ” Practice Location

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