Organization
DAHLONEGA PEDIATRIC & ADOLESCENT MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET PAYNE RNCS, MN, PNP (NURSE PRACTITIONER/OWNER)
(706) 864-6700
Entity
Organization
Contact information
Practice address
1055 GROVE ST N, DAHLONEGA, GA 30533-3876
(706) 864-6700
Mailing address
1055 GROVE ST N, DAHLONEGA, GA 30533-3876
(706) 864-6700
Taxonomy
Speciality
Code
Description
License number
State
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
1639298458
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000489189S
—
GA
Enumeration date
07/26/2016
Last updated
07/26/2016
Update your record
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