Organization
PEDIATRICS AND ADOLESCENT MEDICINE, PA
Active
Other names
pampa
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN SEVIN (PRACTICE ADMINISTRATOR)
(770) 973-4700
Entity
Organization
Contact information
Practice address
2155 POST OAK TRITT RD, SUITE 100, MARIETTA, GA 30062-8620
(770) 973-4700
(770) 973-5460
Mailing address
PO BOX 102613, ATLANTA, GA 30368-2613
(770) 973-4700
(770) 973-5460
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22123
GA
Other
Enumeration date
03/09/2007
Last updated
08/26/2016
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