Provider Demographics
NPI:1740565092
Name:SATURN PEDIATRICS, P.C.
Entity Type:Organization
Organization Name:SATURN PEDIATRICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:B
Authorized Official - Last Name:BADARUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-979-3989
Mailing Address - Street 1:1700 TREE LN
Mailing Address - Street 2:SUITE 160
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6765
Mailing Address - Country:US
Mailing Address - Phone:770-979-3989
Mailing Address - Fax:770-979-4330
Practice Address - Street 1:1700 TREE LN
Practice Address - Street 2:SUITE 160
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6765
Practice Address - Country:US
Practice Address - Phone:770-979-3989
Practice Address - Fax:770-979-4330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000553616AMedicaid