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Organization
DELTA PEDIATRICS,LLC
Active
Organization
DELTA PEDIATRICS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMANUEL E MORDI M.D (MANAGER)
(770) 713-4646
Entity
Organization
Contact information
Practice address
3966 S BOGAN RD, BUILDING B, BUFORD, GA 30519-8633
(770) 713-4646
(404) 201-2923
Mailing address
3966 S BOGAN RD, BUILDING B, BUFORD, GA 30519-8633
(770) 713-4646
(404) 201-2923
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
056894
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112742695E
—
GA
Enumeration date
10/01/2011
Last updated
10/01/2011
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