Provider Demographics
NPI:1114565090
Name:GASTRO HEALTH FOR KIDS INCORPORATED
Entity Type:Organization
Organization Name:GASTRO HEALTH FOR KIDS INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RITU
Authorized Official - Middle Name:
Authorized Official - Last Name:WALIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:470-228-4778
Mailing Address - Street 1:821 DAWSONVILLE HWY STE 250-307
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2636
Mailing Address - Country:US
Mailing Address - Phone:470-228-4778
Mailing Address - Fax:470-220-7333
Practice Address - Street 1:535 JESSE JEWELL PKWY SE STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3772
Practice Address - Country:US
Practice Address - Phone:470-228-4778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Single Specialty