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Organization

MOUNTAINSIDE PEDIATRICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KHAWAJA RAZA MAHMOOD M.D. (SOLE PROPRIETOR)
(706) 253-9898
Entity
Organization

Contact information

Practice address
12 SAMMY MCGHEE BLVD, SUITE 102, JASPER, GA 30143-7711
(706) 253-9898
(706) 253-9896
Mailing address
12 SAMMY MCGHEE BOULAVARD, SUITE 102, JASPER, GA 30143-7711
(706) 253-9898
(706) 253-9896

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
42648
GA

Other

Enumeration date
08/24/2011
Last updated
08/24/2011
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