Provider Demographics
NPI:1467983668
Name:KIDZCARE PEDIATRICS, INC
Entity Type:Organization
Organization Name:KIDZCARE PEDIATRICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AFSHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-812-3678
Mailing Address - Street 1:3772 SATELLITE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5681
Mailing Address - Country:US
Mailing Address - Phone:772-812-3678
Mailing Address - Fax:
Practice Address - Street 1:3772 SATELLITE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5681
Practice Address - Country:US
Practice Address - Phone:772-812-3678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA75590208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty