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Contact Information

PEDIATRIC DIGESTIVE HEALTH AND WELLNESS
3925 HARRISON RD STE 100
LOGANVILLE, GA30052-5898
 Phone: 706-340-4330
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Gastroenterology

2080P0206X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PEDIATRIC DIGESTIVE HEALTH AND WELLNESS · (Female)

NPI Number 1083394266
Status Active
Credentials
Entity Individual
Enumeration date 07/21/2023
Last updated 09/04/2024 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
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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