Organization
CENTER FOR PEDIATRIC WELLNESS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH M. LEDUC M.D. (PRESIDENT)
(404) 389-1600
Entity
Organization
Contact information
Practice address
960 JOHNSON FERRY RD NE, SUITE 315, ATLANTA, GA 30342-1631
(404) 389-1600
(404) 389-1610
Mailing address
960 JOHNSON FERRY RD NE, SUITE 315, ATLANTA, GA 30342-1631
(404) 389-1600
(404) 389-1610
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
034754
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000553781B
—
GA
Enumeration date
06/06/2011
Last updated
06/06/2011
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