Organization
PEDIATRIC CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMJAD IQBAL MD (CEO)
(770) 991-8900
Entity
Organization
Contact information
Practice address
189 MEDICAL WAY, SUITE C, RIVERDALE, GA 30274-4905
(770) 991-8900
(770) 991-8917
Mailing address
189 MEDICAL WAY, SUITE C, RIVERDALE, GA 30274-4905
(770) 991-8900
(770) 991-8917
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
20280
GA
Other
Enumeration date
10/13/2014
Last updated
10/13/2014
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