Provider Demographics
NPI:1114045770
Name:VAISHALI B KUTE, MD LLC
Entity Type:Organization
Organization Name:VAISHALI B KUTE, MD LLC
Other - Org Name:CHATTAHOOCHEE PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VAISHALI
Authorized Official - Middle Name:B
Authorized Official - Last Name:KUTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-667-6967
Mailing Address - Street 1:3155 N POINT PKWY
Mailing Address - Street 2:BUILDING D SUITE 200
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-5481
Mailing Address - Country:US
Mailing Address - Phone:770-667-6967
Mailing Address - Fax:
Practice Address - Street 1:3155 N POINT PKWY
Practice Address - Street 2:BUILDING D SUITE 200
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-5481
Practice Address - Country:US
Practice Address - Phone:770-667-6967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA045526208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000825041CMedicaid
GA000825041DMedicaid