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ENDOHEALTH NPI 1710428305


NPI Information

NPI: 1710428305
Provider Name: ENDOHEALTH
Classification: Pediatrics - 2080P0205X
Entity Type: Organization

Specialization: Pediatric Endocrinology

CLIA Number: 11D2169009

Address:
1690 STONE VILLAGE LN NW STE 207
KENNESAW, GA
ZIP 30152
Phone: (678) 829-6030
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ENDOHEALTH is a pediatric endocrinology pediatrics in Kennesaw, 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. ENDOHEALTH NPI is 1710428305. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1690 STONE VILLAGE LN NW STE 207
KENNESAW, GA
ZIP 30152-778
Phone: (678) 829-6030

The provider's authorized official is Gayathri K Devineni .
The authorized official title is Dr and has the following contact phone number (678) 829-6030.

The CLIA number assigned to this NPI record is 11D2169009 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/15/2017 and was last updated on 3/31/2017.


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 Endocrinology061573GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11619154184OTHERGEORGIANUPIN

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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