Provider Demographics
NPI:1770252843
Name:INSPIRE PEDIATRIC NEUROLOGY LLC
Entity type:Organization
Organization Name:INSPIRE PEDIATRIC NEUROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NAVREET
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-487-0363
Mailing Address - Street 1:3482 KEITH BRIDGE RD STE 335
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-5546
Mailing Address - Country:US
Mailing Address - Phone:404-487-0363
Mailing Address - Fax:
Practice Address - Street 1:3535 PEACHTREE RD NE
Practice Address - Street 2:UNIT #320
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326
Practice Address - Country:US
Practice Address - Phone:404-487-0363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty