Organization
GWENDOLYN A. DELANEY, M.D. LLC
Active
Other names
VICKERY PEDIATRICS AND ADOLESCENT MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN A DELANEY (MANAGING MEMBER)
(678) 990-2501
Entity
Organization
Contact information
Practice address
410 PEACHTREE PKWY STE 4260, CUMMING, GA 30041-7407
(678) 990-2501
(678) 990-2505
Mailing address
410 PEACHTREE PKWY STE 4260, CUMMING, GA 30041-7407
(678) 990-2501
(678) 990-2505
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
049380
GA
2080A0000X
Pediatric Adolescent Medicine Physician
051519
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000885431Q
—
GA
Enumeration date
03/27/2007
Last updated
01/14/2020
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