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Organization
VITAL PEDIATRICS FOR COMPLEX KIDS LLC
Active
Organization
VITAL PEDIATRICS FOR COMPLEX KIDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA SHEARER MD (PRESIDENT)
(404) 310-3252
Entity
Organization
Contact information
Practice address
1086 ARBOR TRCE NE, BROOKHAVEN, GA 30319-5378
(404) 310-3252
Mailing address
1086 ARBOR TRCE NE, BROOKHAVEN, GA 30319-5378
(404) 310-3252
Taxonomy
Speciality
Code
Description
License number
State
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
—
NULL
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
—
—
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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