Provider Demographics
NPI:1235148727
Name:CHILDRENS HEALTHCARE OF ATLANTA CARDIOLOGY INC
Entity Type:Organization
Organization Name:CHILDRENS HEALTHCARE OF ATLANTA CARDIOLOGY INC
Other - Org Name:CHILDREN'S CARDIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-694-1700
Mailing Address - Street 1:2970 BRANDYWINE RD STE 125
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-5528
Mailing Address - Country:US
Mailing Address - Phone:404-256-2593
Mailing Address - Fax:770-488-9401
Practice Address - Street 1:2970 BRANDYWINE RD STE 125
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-5528
Practice Address - Country:US
Practice Address - Phone:404-256-2593
Practice Address - Fax:770-488-9401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP207Medicare ID - Type Unspecified