Organization
TOTAL GRACE PEDIATRICS P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASHIRU A DAWODU M.D. (PHYSICIAN)
(404) 292-8103
Entity
Organization
Contact information
Practice address
900 N HAIRSTON RD # RS, SUITE A, STONE MOUNTAIN, GA 30083-2857
(404) 292-8103
(404) 292-8105
Mailing address
900 N HAIRSTON RD # RS, SUITE A, STONE MOUNTAIN, GA 30083-2857
(404) 292-8103
(404) 292-8105
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
052162
GA
Other
Enumeration date
12/26/2007
Last updated
12/26/2007
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