National Provider Identifier Database

NORTHSIDE MATERNIDAD
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

NORTHSIDE MATERNIDAD
5395 JIMMY CARTER BLVD
SUITE 500
NORCROSS, GA30093-1502
Phone: 678-585-4787
Fax: 470-375-8759
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for NORTHSIDE MATERNIDAD

NPI Number 1477912475
Legal business name
LBN
NORTHSIDE MATERNIDAD
Authorized official NEALE FREEMAN - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 02/18/2016
Last updated 02/18/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 040065
  • GA Medicaid: 003169207A

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.

Reviews for NORTHSIDE MATERNIDAD

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