# PEDIA DOC CHILDREN'S MED CTR

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

## Provider details

- **NPI number:** 1518110451
- **Authorized official:** DR. RACHELLE L. DENNIS-SMITH (MD)
- **Authorized official phone:** (404) 344-2828

## Contact information

- **Practice address:** 3088 CAMPBELLTON RD SW, ATLANTA, GA 30311-5410
- **Practice address phone:** (404) 344-2828
- **Practice address fax:** (404) 344-8384
- **Mailing address:** 3088 CAMPBELLTON RD, SW, ATLANTA, GA 30311-5410
- **Mailing address phone:** (404) 344-2828
- **Mailing address fax:** (404) 344-8384

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | NULL | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2008
- **Last updated:** 10/23/2008