Provider Demographics
NPI:1831289842
Name:CORNERSTONE PEDIATRICS, INC.
Entity Type:Organization
Organization Name:CORNERSTONE PEDIATRICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLIFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-838-0552
Mailing Address - Street 1:8601 BALDWIN PKWY
Mailing Address - Street 2:SUITES 2A & 2B
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-5625
Mailing Address - Country:US
Mailing Address - Phone:678-838-0552
Mailing Address - Fax:678-838-0929
Practice Address - Street 1:8601 BALDWIN PKWY
Practice Address - Street 2:SUITES 2A & 2B
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-5625
Practice Address - Country:US
Practice Address - Phone:678-838-0552
Practice Address - Fax:678-838-0929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA85002868GMedicaid