| Pediatric Clinic, Pc | |
|
189 Medical Way Suite C Riverdale GA 30274-4905 | |
| (770) 991-8900 | |
| (770) 991-8917 |
| Full Name | Pediatric Clinic, Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 189 Medical Way, Riverdale, Georgia |
| Authorized Official Name and Position | Amjad Iqbal (CEO) |
| Authorized Official Contact | 7709918900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Clinic, Pc 189 Medical Way Suite C Riverdale GA 30274-4905 Ph: (770) 991-8900 | Pediatric Clinic, Pc 189 Medical Way Suite C Riverdale GA 30274-4905 Ph: (770) 991-8900 |
| NPI Number | 1902200447 |
|---|---|
| Provider Enumeration Date | 10/13/2014 |
| Last Update Date | 10/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902200447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 20280 (Georgia) | Primary |
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