Organization
PEDIATRIC AND NEONATAL CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABOLHASSAN YAMIN M.D. (CEO)
(770) 949-9985
Entity
Organization
Contact information
Practice address
8503 CAMPBELLTON ST, DOUGLASVILLE, GA 30134-1822
(770) 949-9985
(770) 949-6213
Mailing address
8503 CAMPBELLTON ST, DOUGLASVILLE, GA 30134-1822
(770) 949-9985
(770) 949-6213
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
020501
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000177449E
—
GA
Enumeration date
01/22/2009
Last updated
01/22/2009
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