Organization
VERRAS PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATHANASIOS VERRAS MD (OWNER)
(770) 491-1285
Entity
Organization
Contact information
Practice address
2181 NORTHLAKE PKWY, BLDG 6 SUITE 104, TUCKER, GA 30084-4107
(770) 491-1285
(770) 491-3164
Mailing address
2181 NORTHLAKE PKWY, BLDG 6 SUITE 104, TUCKER, GA 30084-4107
(770) 491-1285
(770) 491-3164
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
022908
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508824392
NPI
—
Enumeration date
05/11/2007
Last updated
02/26/2008
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