Organization
VAN METER PEDIATRIC ENDOCRINOLOGY
Active
Parent organization
ATLANTA DIABETES ASSOCIATES
Other names
Atlanta Diabetes Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
ATLANTA DIABETES ASSOCIATES
Authorized official
MRS. BONNIE L BIDLACK CREDENTIALING CONT (CREDENTIALING)
(404) 788-5237
Entity
Organization
Contact information
Practice address
1800 HOWELL MILL RD NW STE 450, ATLANTA, GA 30318-2508
(678) 961-2100
(678) 961-2107
Mailing address
1800 HOWELL MILL RD NW STE 450, ATLANTA, GA 30318-2508
(404) 355-4393
(678) 961-2107
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
034734
GA
2080P0205X
Pediatric Endocrinology Physician
061122
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000468234G
—
GA
Enumeration date
07/20/2010
Last updated
01/21/2022
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