Woodstock Pediatric Medicine

LBN: Woodstock Pediatric Medicine
Woodstock Pediatric Medicine is an health care organization with primary practice located at 2000 Professional Way Bldg 200, Woodstock GA 30188-4093. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Woodstock Pediatric Medicine can be contacted via phone (770) 517-0250, or through Marulanda, Kelly via phone (770) 517-0250.

Contact Information

Primary practice address
2000 Professional Way Bldg 200 Woodstock GA 30188-4093
Phone: (770) 517-0250
Fax: (770) 517-0260
Website:
Map and Directions
Authorized official contact:
Name: Marulanda, Kelly
Phone: (770) 517-0250

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X Georgia

Profile Details

NPI number 1841402781
LBN Legal business name Woodstock Pediatric Medicine
DBA Doing business as
Authorized official Marulanda, Kelly
Entity Organization
Organization subpart 1 No
Enumeration date May 4th, 2007
Last updated Mar 21st, 2012 - about 12 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 1841402781 NPPES
Georgia MEDICAID 085001488G

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