Organization
CRESCENT PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM MONEIT MD (PRESIDENT)
(770) 495-6222
Entity
Organization
Contact information
Practice address
2925 PREMIERE PKWY, SUITE 140, DULUTH, GA 30097
(770) 495-6222
(770) 495-9959
Mailing address
2925 PREMIERE PKWY, SUITE 140, DULUTH, GA 30097
(770) 495-6222
(770) 495-9959
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
034204
GA
208000000X
Pediatrics Physician
Primary
034204
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000449611C
—
GA
01
—
10037067
AMERIGROUP
—
01
—
1207077
UNITED HEALTHCARE
—
01
—
313452
WELLCARE
—
01
—
4308928
AETNA
GA
01
—
52062819002
BC
GA
01
—
72291
COVENTRY
—
05
—
85001694G
—
GA
01
—
912801
CIGNA
—
Enumeration date
09/07/2006
Last updated
02/01/2011
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