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Organization
PEDIATRICARE PM
Active
Organization
PEDIATRICARE PM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI COOK (BUSINESS MANAGER)
(706) 495-9627
Entity
Organization
Contact information
Practice address
1215 W WHEELER PKWY, AUGUSTA, GA 30909-1899
(706) 868-1906
(706) 868-0150
Mailing address
1215 W WHEELER PKWY, AUGUSTA, GA 30909-1899
(706) 868-1906
(706) 868-0150
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
11/22/2006
Last updated
12/26/2008
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