Suwanee Pediatrics Pc

LBN: Suwanee Pediatrics Pc
Suwanee Pediatrics Pc is an health care organization with primary practice located at 1155 Lawrenceville Suwanee Rd , Lawrenceville GA 30043-5425. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Suwanee Pediatrics Pc can be contacted via phone (678) 442-0205, or through Odusina, Bolaji T via phone (678) 442-0205.

Contact Information

Primary practice address
1155 Lawrenceville Suwanee Rd Lawrenceville GA 30043-5425
Phone: (678) 442-0205
Fax: (678) 442-0185
Website:
Map and Directions
Authorized official contact:
Name: Odusina, Bolaji T Doctor of Medicine (MD)
Phone: (678) 442-0205

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X 042380 Georgia

Profile Details

NPI number 1487886123
LBN Legal business name Suwanee Pediatrics Pc
DBA Doing business as
Authorized official Odusina, Bolaji T Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 13th, 2009
Last updated Feb 25th, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487886123 NPPES
Georgia MEDICAID 647974880B
Georgia MEDICAID 000757567B

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