| Children's Healthcare Of Atlanta At Scottish Rite | |
|
1001 Johnson Ferry Rd Ne Atlanta GA 30342-1605 | |
| (404) 785-5252 | |
| Not Available |
| Full Name | Children's Healthcare Of Atlanta At Scottish Rite |
|---|---|
| Speciality | Pediatrics |
| Location | 1001 Johnson Ferry Rd Ne, Atlanta, Georgia |
| Authorized Official Name and Position | Louetta Cody (MANAGER, PROVIDER ENROLLMENT) |
| Authorized Official Contact | 4047857876 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Healthcare Of Atlanta At Scottish Rite 1575 Northeast Expy Ne Brookhaven GA 30329-2401 Ph: () - | Children's Healthcare Of Atlanta At Scottish Rite 1001 Johnson Ferry Rd Ne Atlanta GA 30342-1605 Ph: (404) 785-5252 |
| NPI Number | 1184779332 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 03/24/2023 |
| Certification Date | 03/24/2023 |
| Medicare PECOS PAC ID | 4981506581 |
|---|---|
| Medicare Enrollment ID | O20040123000663 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184779332 | NPI | - | NPPES |
| Provider Name | Amina M Bhatia |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528151859 PECOS PAC ID: 3971567470 Enrollment ID: I20041115000956 |
| Provider Name | Megan M Durham |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1760583710 PECOS PAC ID: 8820198096 Enrollment ID: I20070717000638 |
| Provider Name | Kuan-yueh Chiang |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700835832 PECOS PAC ID: 4183807290 Enrollment ID: I20110328000650 |
| Provider Name | Kurt Heiss |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326135591 PECOS PAC ID: 6901084482 Enrollment ID: I20110705000333 |
| Provider Name | Matthew Steven Clifton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457485815 PECOS PAC ID: 4183892581 Enrollment ID: I20110728000591 |
| Provider Name | Mark L Wulkan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053409698 PECOS PAC ID: 2769651793 Enrollment ID: I20110809000529 |
| Provider Name | Paul M Parker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588751754 PECOS PAC ID: 3577543586 Enrollment ID: I20110823000677 |
| Provider Name | Hong Yin |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1336106269 PECOS PAC ID: 3375578891 Enrollment ID: I20121128000452 |
| Provider Name | Shelley A Caltharp |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1376786392 PECOS PAC ID: 5698091486 Enrollment ID: I20150314000124 |
| Provider Name | Matthew T Santore |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568519098 PECOS PAC ID: 7214255371 Enrollment ID: I20150421002168 |
| Provider Name | Karen Wasilewski |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1487604443 PECOS PAC ID: 9436462025 Enrollment ID: I20160302002521 |
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