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Organization

PEACH STATE PEDIATRICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MOHAMMED WARIS MD (OWNER)
(850) 270-9249
Entity
Organization

Contact information

Practice address
3001 S COBB DR SE, SUITE 107, SMYRNA, GA 30080-7874
(850) 875-3600
Mailing address
3001 S COBB DR SE, SUITE 107, SMYRNA, GA 30080-7874

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
62300
GA

Other

Enumeration date
10/16/2012
Last updated
10/16/2012
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