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Contact Information

PEDIATRIC CARDIOLOGY SERVICES LLC
1380 MILSTEAD AVE NE
SUITE J
CONYERS, GA30012-3864
 Phone: 770-995-6684
 Fax: 770-995-7631
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PEDIATRIC CARDIOLOGY SERVICES LLC · (Female)

NPI Number 1467613232
Status Active
Credentials
Entity Individual
Enumeration date 06/24/2008
Last updated 06/24/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 043298
  • GA Medicaid 000326873G
  • GA Medicaid 00740891A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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