# VITAL PEDIATRICS FOR COMPLEX KIDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235726837
- **Authorized official:** PATRICIA SHEARER MD (PRESIDENT)
- **Authorized official phone:** (404) 310-3252

## Contact information

- **Practice address:** 1086 ARBOR TRCE NE, BROOKHAVEN, GA 30319-5378
- **Practice address phone:** (404) 310-3252
- **Mailing address:** 1086 ARBOR TRCE NE, BROOKHAVEN, GA 30319-5378
- **Mailing address phone:** (404) 310-3252

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080H0002X | Pediatric Hospice and Palliative Medicine Physician | — | NULL | Yes |
| 2080H0002X | Pediatric Hospice and Palliative Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/29/2020
- **Last updated:** 12/29/2020