Provider Demographics
NPI:1821109042
Name:PIEDMONT KIDS CARE
Entity Type:Organization
Organization Name:PIEDMONT KIDS CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHER
Authorized Official - Middle Name:
Authorized Official - Last Name:GAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-447-2800
Mailing Address - Street 1:612 CALHOUN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PIEDMONT
Mailing Address - State:AL
Mailing Address - Zip Code:36272-1939
Mailing Address - Country:US
Mailing Address - Phone:256-447-2800
Mailing Address - Fax:256-447-2255
Practice Address - Street 1:612 CALHOUN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:PIEDMONT
Practice Address - State:AL
Practice Address - Zip Code:36272-1939
Practice Address - Country:US
Practice Address - Phone:256-447-2800
Practice Address - Fax:256-447-2255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23189208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALG58796Medicare UPIN