NPI 1548252562

Southern Crescent Pediatrics PC

Organisation Pediatrics Physician Riverdale, GA

Practice location

Address: 6584 Professional Pl STE C, Riverdale, GA 30274-4942
Phone: (770) 996-9225
Fax: (770) 997-6812
Mailing address: 150 Medical Blvd STE B, Stockbridge, GA 30281-5053

Authorised official

Name: Juan Jose Sherwood
Title: President
Phone: (770) 389-9944

Registered specialties

Pediatrics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208000000X

Other Pediatrics providers in Georgia →

Registry record

NPI: 1548252562
Entity type: Organization
NPI issued: 16 Aug 2005
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.