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PEDIATRIC ENDOCRINE SPECIALISTS OF GEORGIA NPI 1366721706


NPI Information

NPI: 1366721706
Provider Name: PEDIATRIC ENDOCRINE SPECIALISTS OF GEORGIA
Classification: Pediatrics - 2080P0205X
Entity Type: Organization

Specialization: Pediatric Endocrinology

CLIA Number: 11D2031487

Address:
10700 MEDLOCK BRIDGE RD
SUITE 102
DULUTH, GA
ZIP 30097
Phone: (678) 691-5351
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PEDIATRIC ENDOCRINE SPECIALISTS OF GEORGIA is a pediatric endocrinology pediatrics in Duluth, GA. The provider is a pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. PEDIATRIC ENDOCRINE SPECIALISTS OF GEORGIA NPI is 1366721706. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10700 MEDLOCK BRIDGE RD
SUITE 102
DULUTH, GA
ZIP 30097-456
Phone: (678) 691-5351
Fax: (770) 685-1241

The provider's authorized official is Paul Jerome Bernard .
The authorized official title is President and has the following contact phone number (314) 374-1646.

The CLIA number assigned to this NPI record is 11D2031487 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/16/2011 and was last updated on 3/30/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080P0205XPediatricsPediatric Endocrinology60045GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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